Surgical management of instrumentation-induced coronary artery dissection.

ABSTRACT

The mechanism of instrument-induced coronary artery dissections (IICDs) is briefly presented. Depending on the coronary anatomy, three different situations that may occur are distinguished (1) major coronary branches between the site of dissection and planned anastomosis; (2) no important collaterals at the same location; and (3) perforation of the coronary artery. Surgical methods applicable to each for the correction of these situations is presented.