Author + information
- Received February 3, 2015
- Accepted February 12, 2015
- Published online June 1, 2015.
- Kohei Koyama, MD, PhD∗ (, )
- Kihei Yoneyama, MD, PhD,
- Maya Tsukahara, MD,
- Shingo Kuwata, MD,
- Takanobu Mitarai, MD,
- Ryo Kamijima, MD,
- Yuki Ishibashi, MD, PhD,
- Yasuhiro Tanabe, MD,
- Ken Kongoji, MD, PhD,
- Tomoo Harada, MD, PhD and
- Yoshihiro J. Akashi, MD, PhD
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
- ↵∗Reprint requests and correspondence:
Dr. Kohei Koyama, Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki-City, Kanagawa 216-8511, Japan.
A 47-year-old man presented to our hospital after he was successfully resuscitated from ventricular fibrillation. He had experienced chest pain while seated at home. He had undergone successful sequential coronary artery bypass grafting 17 months previously, by the use of left internal mammary artery (LIMA) grafts to the left anterior descending artery and the left circumflex artery and a saphenous vein graft to the right coronary artery. Angiography showed dissection with severe stenosis at the middle body of the LIMA (Figure 1A). Intravascular ultrasound and optical coherence tomography revealed dissection at the LIMA (Figure 1B, Online Video 1). Two stents were employed to cover the entire lesion. A few cases of internal mammary artery dissection after physical movement have been reported (1); however, to our knowledge, no previous report has described spontaneous dissection in a LIMA graft causing acute coronary syndrome without an external factor.
For a supplemental video, please see the online version of this article.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 3, 2015.
- Accepted February 12, 2015.
- American College of Cardiology Foundation