title: Intraoperative coronary artery dissection in fibromuscular dysplasia.
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.
authors.affiliation: Department of Cardiothoracic Surgery, Northwestern University, Chicago, Illinois.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Lou
authors.affiliation: Department of Cardiothoracic Surgery, Northwestern University, Chicago, Illinois.
authors.forename: Sumeet S
authors.initials: SS
authors.lastname: Mitter
authors.affiliation: Department of Cardiothoracic Surgery, Northwestern University, Chicago, Illinois.
authors.forename: John E
authors.initials: JE
authors.lastname: Blair
authors.affiliation: Department of Cardiothoracic Surgery, Northwestern University, Chicago, Illinois.
authors.forename: Keith
authors.initials: K
authors.lastname: Benzuly
authors.affiliation: Department of Cardiothoracic Surgery, Northwestern University, Chicago, Illinois.
authors.forename: Ivancarmine
authors.initials: I
authors.lastname: Gambardella
authors.affiliation: Department of Cardiothoracic Surgery, Northwestern University, Chicago, Illinois. Electronic address: cmalaisr@nmh.org.
authors.forename: S Chris
authors.initials: SC
authors.lastname: Malaisrie
mesh_terms: D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000379:methods; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000379:methods; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome