Coronary artery dissection after surgical cryoablation procedure.

Doguet, Fabien; Le Guillou, Vincent; Litzler, Pierre Yves; Bouchart, François; Nafeh-Bizet, Catherine; Cribier, Alain; Bessou, Jean Paul · Ann Thorac Surg · 2009

case_report · Level V

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Abstract

Cryoablation can be used to treat atrial fibrillation (AF) surgically. We describe a 71-year-old woman who underwent cryoablation after 6 months of AF. Four hours post-surgery, electrocardiographic changes were observed in the circumflex artery territory associated with hemodynamic instability, which responded to inotropic agents. Angiography revealed a diffuse circumflex artery spasm with a heterogeneous aspect of the posterior branch evoking a dissection. Platelet anti-aggregant and trinitrine therapy were started. Recovery was uneventful and the patient was discharged on day 13. Cryoablation-associated circumflex artery dissection is rare. Caution is required when locating the ablation lines to avoid coronary artery injury.

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