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Spontaneous left main coronary artery dissection, possibly due to cystic medial necrosis found in the internal mammary arteries

Department of Cardiothoracic Surgery, Drexel University College of Medicine, Philadelphia, PA, USA

Corresponding author.

E-mail address: genex{at}nifty.com (H. Hirose).

A 55-year-old male without previous medical history developed chest pain. Coronary catheterization showed left main coronary dissection. Coronary artery bypass grafting was performed using bilateral internal mammary arteries, which were very fragile. The specimens of the internal mammary arteries sent for pathology showed cystic medial necrosis.

Key Words: Coronary dissection; Cystic medial necrosis; Internal mammary artery

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				N. Barbetakis, C. Lafaras, A. Efstathiou, and I. Fessatidis eComment: Routine preoperative evaluation of the internal mammary artery as conduit for coronary patients. Is it worth? Interactive CardioVascular and Thoracic Surgery, October 1, 2009; 9(4): 727 - 727. [Full Text] [PDF]