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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1999 August;40(4):531-3

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Spontaneous dissection of coronary artery in a patient with ascending aortic aneurysm and aortic valve regurgitation

Di Bartolomeo R., Pacini D., Nicolini F., Giancola R., Pierangeli A.

From the Department of Cardiac Surgery University of Bologna, Italy


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Spon­ta­neous cor­o­nary ­artery dis­sec­tion is a ­rare ­cause of myo­car­dial infarc­tion asso­ciated ­with a sig­nif­i­cant ­high mor­bidity and mor­tality. It usu­ally ­occurs in rel­a­tively ­young ­patients and it is fre­quently ­found at ­autopsy. We ­report a ­case of a 42-­year-old ­woman, who under­went resec­tion of sub­aortic dia­phragm ten ­years ear­lier pre­senting ­with pos­tero-lat­eral myo­car­dial infarc­tion. Cor­o­nary arter­i­og­raphy ­revealed a dis­sec­tion of the ­left ­main ­stem ­extending dis­tally to the ­left ante­rior ­descending ­artery (LAD) and cir­cum­flex ­artery (Cx); occlu­sion of the pos­tero-lat­eral ­branch of the Cx; ­severe ­aortic ­valve regur­gi­ta­tion and ­ascending ­aortic aneu­rysm. She was suc­cess­fully oper­ated on in emer­gency and under­went myo­car­dial revas­cu­lar­iza­tion and sep­arate replace­ment of the ­aortic ­valve and the ­ascending ­aorta. In ­this spe­cific ­case of cor­o­nary dis­sec­tion and ­severe ­aortic regur­gi­ta­tion it is man­da­tory to per­form sur­gery in emer­gency to ­limit infarc­tion evo­lu­tion and ­avert ­loss of ­life.

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