Key result
Emergency CABG successfully treats pregnancy-associated SCAD in a 30-year-old woman after failed PCI.
Case Report (n=1)
No
This case highlights the challenges in managing pregnancy-associated spontaneous coronary artery dissection, demonstrating that PCI can lead to instability requiring emergency CABG.
Answers are grounded in this paper and cite their sources.
May require surgical backup for PCI in pregnancy-associated SCAD; leaves open optimal strategies pending prospective data.
A 30-year-old woman in her second pregnancy, which was complicated by gestational diabetes mellitus. She had an uneventful spontaneous vaginal delivery at 38 weeks+3 days of gestation. Day 1 postpartum, she developed sudden chest pain radiating to her jaw and neck. Her observations were normal, and ECG showed lateral ST elevation in keeping with acute myocardial infarction. The troponin-T level was elevated at 21 ng/L at 0 hour, and >10 000 ng/L at 12 hours, respectively. Coronary angiography confirmed spontaneous dissection of the proximal left anterior descending (LAD) and proximal circumflex coronary arteries. She became unstable during percutaneous coronary intervention and consequently had a successful coronary artery bypass surgery with left saphenous vein grafts to the first obtuse marginal artery and LAD. Echocardiogram revealed moderate to severe impairment of the left ventricular function postoperatively.
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Igbokwe et al. (2021) conducted a case report in Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) (n=1). Coronary artery bypass surgery (CABG) was evaluated. A 30-year-old woman with pregnancy-associated spontaneous coronary artery dissection successfully underwent emergency coronary artery bypass surgery after unsuccessful percutaneous coronary intervention.
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