Abstract
BackgroundMultiple coronary artery dissection is rare after cardiac surgery. It is difficult to recognize and is easily misdiagnosed as low output syndrome as a result of cardiopulmonary bypass (CPB).Case presentationA 43-year-old woman who had undergone cardiac surgery presented with unstable hemodynamics, and progressively increasing lactate, B-type natriuretic peptide, and cardiac enzyme levels, along with electrocardiogram (ECG) changes. Angiography indicated the presence of severe multiple coronary artery dissection, and 3 stents were implanted, which improved the patient’s hemodynamic status and cardiac function.ConclusionsIn the present report, we describe our experience with identifying and treating delayed severe multiple coronary artery dissection caused by cardiac surgery. Timely angiography is vital in patients suspected with coronary artery dissection, and percutaneous coronary intervention (PCI) should be considered as a treatment strategy for cases with severe multiple coronary artery dissection and unstable hemodynamics after cardiac surgery.
Highlights
Multiple coronary artery dissection is rare after cardiac surgery
Guo Xue Alley, Chengdu, Sichuan 610041, People’s Republic of China (ECG) changes in a patient who had undergone cardiac surgery via transradial angiography, and was treated via implantation of 3 stents. This rare case highlights the importance of prompt detection via angiography in patients strongly suspected of having coronary artery dissection, as well as treatment via percutaneous coronary intervention (PCI) for those diagnosed with severe multiple coronary artery dissection with unstable hemodynamics after cardiac surgery
Only few reports have described the treatment of multiple coronary artery dissection after cardiac surgery through PCI [3]
Summary
Multiple coronary artery dissection is rare after cardiac surgery. It is difficult to recognize and is misdiagnosed as low output syndrome as a result of cardiopulmonary bypass (CPB).Case presentation: A 43-year-old woman who had undergone cardiac surgery presented with unstable hemodynamics, and progressively increasing lactate, B-type natriuretic peptide, and cardiac enzyme levels, along with electrocardiogram (ECG) changes. Multiple coronary artery dissection rarely develops following cardiac surgery, and may result from the direct coronary ostia cannulation performed for cardioplegia solution delivery [2]. We describe a case of successful detection of multiple coronary artery dissection through blood biochemical and electrocardiography
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