Coronary computed tomography-angiography for traumatic coronary artery transection

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Diagnostic Imaging

Background:

• Penetrating thoracic trauma is rarely fatal.
• Coronary artery transection is a rare but lethal injury.
• Successful treatment of cardiac stab wounds with coronary artery transection is possible with prompt diagnosis.

Observation:

• A 36-year-old male presented with a left chest stab wound.
• Computed tomography-angiography revealed left hemopneumothorax and left anterior descending artery transection.
• Ischemic changes were noted in the left ventricular myocardium.

Findings:

• Coronary artery bypass surgery was successfully performed using the left internal thoracic artery.
• The patient recovered well and was discharged 18 days post-surgery.
• No major complications were observed during the postoperative period.

Implications:

• Preoperative computed tomography scans with coronary angiography are valuable for diagnosing coronary artery injuries.
• This diagnostic approach aids in planning surgical interventions for high-risk patients.
• Early and accurate diagnosis can lead to successful outcomes in rare, severe cardiac trauma cases.