[Coronary arterial dissection following selective coronary artery perfusion]

Dissection of the three coronary vessels as a rare fatal complication after intraoperative cannulation is described. A 58-year-old man died from progressive cardiac failure 12 days after mitral and aortic valve replacement. The cause of death was a nearly 12-day-old anteroseptal myocardial infarction as a result of a dissection of all three coronary vessels including the septal arteries. Histologic examination revealed a tear of the left and right coronary artery at their ostia. Thrombi of different age in the dissection and satellite-like recent necroses surrounding the 12-day-old myocardial infarction indicate a gradual progression of the dissection.