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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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CASE REPORTS  CARDIAC SECTION


The Journal of Cardiovascular Surgery 2002 April;43(2):189-93

language: English

Emergency management of spontaneous coronary artery dissection

Bonacchi M. 1, Prifti E. 1,2, Giunti G. 1, Frati G. 2, Leacche M. 2, Brancaccio G. 1, Sani G. 1

From ­the
1 Chair of Cardiac Surgery University ­of Florence, Florence, Italy
2 ­IRCCS Neuromed, Pozzilli, Isernia, Italy


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Six cas­es of spon­ta­ne­ous cor­o­nary arter­ies dis­sec­tion ­are report­ed. In ­one ­patient, ­triple ves­sel spon­ta­ne­ous cor­o­nary ­artery dis­sec­tion ­was iden­ti­fied. Another ­patient pre­sent­ed spon­ta­ne­ous ­left ­main cor­o­nary ­artery dis­sec­tion. In ­one ­case we ­found ­the spon­ta­ne­ous dis­sec­tion of ­the ­left ante­ri­or descend­ing ­artery asso­ciat­ed ­with dis­tal aor­tic ­arch dis­sec­tion. These con­di­tions ­are ­very ­rare ­and ­may ­present a sur­gi­cal dilem­ma. Causative fac­tors ­and under­ly­ing pathol­o­gy ­are clar­i­fied. Prompt diag­no­sis ­and sur­gi­cal inter­ven­tion is ­safe ­and effec­tive. Early rec­og­ni­tion of ­left ­main cor­o­nary ­artery dis­sec­tion or ­three-ves­sel dis­sec­tion is essen­tial ­because ­urgent cor­o­nary ­artery ­bypass graft­ing ­may be ­life sav­ing.

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