Staged Therapeutic Approach in Spontaneous Coronary Dissection

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Presentation transcript:

Staged Therapeutic Approach in Spontaneous Coronary Dissection Siamak Aliyary, MD, Massimo A. Mariani, MD, PhD, Patrick M.J. Verhorst, MD, PhD, Marc Hartmann, MD, Martin G. Stoel, MD, Clemens von Birgelen, MD, PhD The Annals of Thoracic Surgery Volume 83, Issue 5, Pages 1879-1881 (May 2007) DOI: 10.1016/j.athoracsur.2006.11.085 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Panels A–C: Initial coronary angiography showed a normal right coronary artery (RCA) (A), a dissection of the left anterior descending artery (LAD) proximal of the first septal branch with occlusion of a diagonal branch (B, C), and only a slight lumen narrowing of the proximal left circumflex artery (LCX) without evidence of a dissection membrane in the LCX (B, C). Panels D–F: Short-term angiographic follow-up after cesarean section showed no change in the RCA (D), but antegrade propagation of the dissection into the mid-LAD with occlusion of several septal branches (E, F) and development of small collaterals from the RCA (D; arrow). In addition, the retrograde spiral dissection through the main stem into the mid-LCX had become worse and resulted in significant lumen narrowing of the LCX (E, F). The Annals of Thoracic Surgery 2007 83, 1879-1881DOI: (10.1016/j.athoracsur.2006.11.085) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions