Intraoperative coronary artery dissection in fibromuscular dysplasia

Ann Thorac Surg. 2015 Apr;99(4):1442-4. doi: 10.1016/j.athoracsur.2014.06.107.

Abstract

A 61-year-old woman with bicuspid aortic stenosis, an ascending aortic aneurysm, and a remote history of renal fibromuscular dysplasia underwent aortic root replacement complicated by extensive dissection of the left circumflex artery extending retrograde into the left anterior descending artery. This was managed by coronary artery bypass grafting, left ventricular support, and percutaneous coronary intervention for propagation of the dissection. This case highlights the prevalence, diagnosis, and management of intraoperative coronary dissection secondary to fibromuscular dysplasia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / etiology*
  • Aortic Dissection / surgery
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / methods*
  • Cardiopulmonary Bypass / methods
  • Coronary Aneurysm / diagnostic imaging
  • Coronary Aneurysm / etiology*
  • Coronary Aneurysm / surgery
  • Coronary Angiography / methods
  • Coronary Artery Bypass / methods
  • Echocardiography, Doppler / methods
  • Female
  • Fibromuscular Dysplasia / complications*
  • Fibromuscular Dysplasia / diagnosis
  • Fibromuscular Dysplasia / surgery
  • Follow-Up Studies
  • Humans
  • Intraoperative Complications / diagnostic imaging
  • Intraoperative Complications / etiology*
  • Intraoperative Complications / surgery
  • Middle Aged
  • Risk Assessment
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome