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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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Staged therapeutic approach in spontaneous coronary dissection
Siamak Aliyary1, Massimo A Mariani, Patrick M J Verhorst
1Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands.
The Annals of Thoracic Surgery
|April 28, 2007
Summary
Spontaneous coronary artery dissection is a rare pregnancy complication causing heart attack. This case highlights successful management including cesarean delivery and bypass surgery.
Area of Science:
- Cardiology
- Obstetrics
- Cardiovascular Surgery
Background:
- Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial infarction, particularly in pregnant women during the peripartum or postpartum period.
- Early diagnosis via coronary angiography is crucial for determining the optimal therapeutic strategy.
Observation:
- A 36-year-old pregnant woman at 36 weeks gestation presented with cardiogenic shock and acute anterolateral myocardial infarction.
- The infarction was attributed to spontaneous coronary artery dissection.
Findings:
- The patient underwent emergent cesarean section while supported by intra-aortic balloon counterpulsation, resulting in the delivery of a healthy infant.
- Following delivery, the patient successfully underwent off-pump coronary artery bypass surgery.
Implications:
- This case demonstrates a successful multidisciplinary approach to managing SCAD in pregnancy.
- It underscores the feasibility of timely intervention, including surgical revascularization, in this high-risk obstetric population.
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