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[Spontaneous coronary artery dissection with left ventricular aneurysm--a case report of successful surgical repair]
Insights
Spontaneous coronary artery dissection is rare, but this case shows successful surgical repair for coronary dissection and left ventricular aneurysm. This highlights a viable treatment option for complex cardiac conditions.
Area of Science:
- Cardiology
- Vascular Surgery
- Cardiac Surgery
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of myocardial infarction.
- Surgical management for SCAD, especially with left ventricular aneurysm, is rarely reported.
Observation:
- A 56-year-old male with prior myocardial infarction presented with SCAD affecting the left anterior descending (LAD) and first diagonal artery.
- Coronary angiography revealed arterial dilatation and intimal separation within the LAD and first diagonal branch.
- A large left ventricular myocardial aneurysm was identified in the anteroapical walls.
Findings:
- The patient underwent successful open-heart surgery.
- Surgical procedures included left ventricular myocardial aneurysmectomy and aorto-first diagonal branch saphenous vein graft.
- This represents the second reported case of successful surgical treatment for SCAD with associated left ventricular aneurysm.
Implications:
- Successful surgical intervention is feasible for SCAD complicated by left ventricular aneurysm.
- This case expands the understanding of operative treatment options for rare coronary artery pathologies.
- Further research into optimal surgical strategies for SCAD with complex cardiac structural abnormalities is warranted.
Abstract:
Spontaneous coronary artery dissection is a rare entity. To our knowledge, 86 cases have been reported, and there are 7 operative treatment. The patient was 56 year-old male with a history of the previous myocardial infarction. A selective coronary angiography demonstrated marked dilatation of both coronary arteries. The thin radiolucent lines were shown within the LAD and first diagonal branch as a result of partial separation of the intima. A very large left ventricular myocardial aneurysm was also demonstrated within anteroapical walls, he underwent open heart surgery with left ventricular myocardial aneurysmectomy and aorto-first diagonal branch saphenous vein graft. This present case is the second report which describe a successful surgical treatment for the spontaneous coronary artery dissection with left ventricular aneurysm.