Abstract
Iatrogenic Dissection of Left Main Stem Coronary Artery Necessitating Emergency Coronary Artery Bypass Grafting: A Rare Life Threatening Complication of Diagnostic Coronary Angiography
Highlights
Coronary angiography is the investigation of choice to understand coronary anatomy
Her past medical history included well controlled systemic hypertension, non-insulin dependent diabetes mellitus and she was an ex-smoker. On examination she was in sinus rhythm and cardiovascular examination was unremarkable. She proceeded to coronary angiogram which was performed through a right radial artery approach
Journal of Cardiology & Cardiovascular Therapy involving the left main stem (LMS) and left anterior descending artery (LAD) a decision was made to transfer the patient for emergency coronary artery bypass grafting (CABG) surgery rather than consider bail-out stenting
Summary
Iatrogenic Dissection of Left Main Stem Coronary Artery Necessitating Emergency Coronary. While performing the left side heart angiogram and injecting the contrast through the left coronary Ostia, an immediate dissection of the left main stem (LMS) coronary artery with extension into the left anterior descending (LAD) coronary artery was noted, (Figure 1) During this time the patient reported severe sharp chest pain radiating to her left shoulder with associated dyspnea. Journal of Cardiology & Cardiovascular Therapy involving the LMS and LAD a decision was made to transfer the patient for emergency coronary artery bypass grafting (CABG) surgery rather than consider bail-out stenting. She underwent an emergency CABG using the left internal mammary artery to mid LAD and a saphenous vein graft to the intermediate artery. Her post-operative transthoracic echocardiogram showed good left ventricular function
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