Undiagnosed Type C Coronary Artery Dissection and Prompt Surgical Management

An Aortic dissection results due to intimal tear, causing passage of blood into the media creating a false channel. This dissected channel can extend proximally or distally, causing any branch artery to compromise or rupture. Acute aortic dissection is a very fatal condition having high risk of mortality. Involvement of the coronary artery in acute aortic dissection is a very rare condition [1] but if involved, has fatal results for the patient. Since, it involves high mortality, coronary malperfusion should be actively looked in all proximally aortic dissection patients. Coronary angiogram, contrast enhanced CT and Transesophageal Echocardiography are the diagnostics used for aortic and coronary dissection. Surgical management gets very complicated if coronaries get involved in aortic dissection, since patients usually need to undergo an additional bypass grafting distal to dissecting coronary artery with closure of the main ostia. Here, we describe an uncommon surgical management of a very rare case in a patient with chronic aortic dissection involving type C right coronary ostial dissection that could not be shown by CECT and TEE, and was diagnosed on table with effective local repair. This Case Study was approved by our local ethics committee, and individual patient consent was taken. The authors have no conflicts of interest to declare. Funding: None