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Survival after spontaneous primary left main coronary artery dissection. Acute surgical intervention with the Jarvik
The Journal of Cardiovascular Surgery
|September 1, 1989
Insights
Spontaneous coronary artery dissection, though rare, can be fatal. This case highlights a woman
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Spontaneous primary dissection of a coronary artery is a rare condition.
- Dissection involving the left main coronary artery is particularly dangerous and often fatal.
Observation:
- A 41-year-old woman experienced spontaneous primary dissection of her left main coronary artery.
- This led to myocardial infarction and cardiogenic shock.
Findings:
- The patient survived this catastrophic event.
- She required a temporary artificial heart (Jarvik 7-70) for life support.
- An orthotopic cardiac transplant was successfully performed.
Implications:
- This case demonstrates the possibility of survival from left main coronary artery dissection.
- It underscores the role of mechanical circulatory support and heart transplantation in managing such critical cases.
Abstract:
Spontaneous primary dissection of a coronary artery is extremely rare, and when it involves the left main trunk the outcome is catastrophic. A 41-year-old woman who survived such a dissection and resultant myocardial infarct with cardiogenic shock is reported here. The patient required a Jarvik 7-70 artificial heart to sustain life until an orthotopic cardiac transplant was performed, and she is now alive and well.