Successful emergency surgery on triple-vessel spontaneous coronary artery dissection

Area of Science:

• Cardiology
• Vascular Surgery
• Cardiovascular Research

Background:

• Spontaneous Coronary Artery Dissection (SCAD) is an increasingly recognized cause of myocardial infarction, particularly in younger women.
• While SCAD cases are rising, complex presentations involving multiple coronary arteries remain challenging to manage.
• Optimal treatment strategies for extensive SCAD, especially triple-vessel involvement, are not well-established.

Observation:

• A 42-year-old female presented with acute myocardial infarction, ongoing chest pain, and acute heart failure.
• Initial treatment with thrombolysis was unsuccessful in resolving the critical coronary artery blockages.
• Diagnostic imaging revealed spontaneous coronary artery dissection affecting all three major coronary arteries.

Findings:

• The patient underwent emergency coronary artery bypass grafting (CABG) as a life-saving intervention.
• This represents the first documented successful surgical myocardial revascularization for triple-vessel SCAD.
• The procedure successfully restored blood flow to the affected myocardium.

Implications:

• This case demonstrates the feasibility and success of CABG in complex, extensive SCAD cases.
• Surgical revascularization may be a viable option for patients with triple-vessel SCAD who fail conservative or less invasive treatments.
• Further research is warranted to define the role of surgical intervention in the management of severe SCAD.