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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 70-year-old man was admitted to our hospital for non-ST-elevation acute coronary syndrome&#46; Coronary angiography showed left main artery and two-vessel disease&#46; Left ventricular function and contractility were normal&#46; Surgical revascularization was decided by the heart team&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Off-pump surgery was performed because of porcelain aorta &#40;left internal mammary to anterior descending artery and saphenous vein to posterior descending and posterolateral arteries&#41;&#46; Three hours after surgery the patient developed progressive hypotension with anterolateral hypokinesia&#44; left ventricular dysfunction and an episode of ventricular fibrillation&#46; Pericardial effusion was excluded&#46; During cardiopulmonary resuscitation &#40;CPR&#41;&#44; chest tubes showed active bleeding and severe pericardial effusion was observed&#46; After 40 minutes of CPR death was confirmed&#46; The autopsy showed aortic rupture &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#44; asterisk&#41; with preserved bypass anastomoses &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Active bleeding immediately after cardiac surgery is mostly caused by a complication of the surgical procedure&#46; We present images of a rare case of a ruptured aorta as an exceptional and lethal complication of CPR that may have been precipitated by the proximity of the saphenous vein anastomosis to a highly calcified and stiff aorta &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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