Spontaneous coronary artery dissection surgery

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Spontaneous Coronary Artery Dissection Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Spontaneous coronary artery dissection from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Approach

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Angiography

CT

MRI

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Treatment Approach

Medical Therapy

Percutaneous Coronary Intervention

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Type 1

Type 2A

Type 2B

Type 3

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A. Arzu Kalayci, M.D. [2]

Synonyms and keywords: SCAD

Overview

Surgery

Emergent CABG should be considered for patients with left main dissections, extensive dissections involving proximal arteries, or in patients in whom PCI failed or who are not anatomically suitable for PCI. Indications for surgical revascularization (CABG)[1] include:

  • Multivessel involvement
  • Left main coronary artery involvement
  • Progression/worsening of dissection so long as there is a distal target
  • Significant narrowing of the arterial lumen
  • Refractory or recurrent myocardial ischemia

In the event of severe refractory heart failure, heart transplantation may be considered.

References

  1. Shamloo BK, Chintala RS, Nasur A; et al. (2010). "Spontaneous coronary artery dissection: aggressive vs. conservative therapy". The Journal of Invasive Cardiology. 22 (5): 222–8. PMID 20440039.