Coronary Artery Bypass Grafting and Thrombectomy for Multiple Spontaneous Coronary Artery Dissection
- VernacularTitle:多発の特発性冠動脈解離による心機能低下および左室心尖部血栓に対して冠動脈バイパス術と血栓摘除を行った1例
- Author:
Ryoichi TSURUHARA
1
;
Yukihiro HAYATSU
2
;
Masaaki NAGANUMA
2
;
Naoya TERAO
2
;
Hayate NOMURA
2
;
Kazuhiro YAMAYA
2
;
Masaki HATA
2
Author Information
- Keywords: spontaneous coronary artery dissection; coronary artery bypass grafting; left ventricular thrombus
- From:Japanese Journal of Cardiovascular Surgery 2025;54(1):14-17
- CountryJapan
- Language:Japanese
- Abstract: A 45-year-old male presented to a hospital for shortness of breath and palpitations, and an electrocardiogram abnormality was identified. Coronary angiography showed multiple spontaneous coronary artery dissection (SCAD) on the left anterior descending artery (LAD) and the right coronary artery (RCA）. Optical coherence tomography showed the LAD had two lumens, and the RCA had multiple lumens by SCAD. Furthermore, computed tomography depicted a bulky thrombus on the left ventricular apex. All lesions were revascularized with arterial grafts, and the concomitant thrombectomy was performed for the thrombus on the apex. The coronary arteries were clearly dissected, and the anastomosis was made to what appeared to be a true lumen based on various intraoperative assessments. The flow pattern and flow volume through the grafts were satisfactory using the ultrasound Doppler method. The patient's postoperative course was uneventful, and he was discharged on postoperative day 22. All grafts have been patent, and the cardiac function has remained improved for 2.5 years of follow-up in our outpatient clinic.
