Spontaneous left main coronary artery dissection, possibly due to cystic medial necrosis found in the internal mammary arteries.

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This is a link to an open access article. This article has been peer reviewed and is published in Interactive Cardiovascular and Thoracic Surgery 2009 Oct;9(4):725-7. The published version is available at DOI: 10.1510/icvts.2009.210989. ©Oxford University Press


A 55-year-old male without previous medical history developed chest pain. Coronary catheterization showed left main coronary dissection. Coronary artery bypass grafting was performed using bilateral internal mammary arteries, which were very fragile. The specimens of the internal mammary arteries sent for pathology showed cystic medial necrosis.