Key result
IVUS confirms rare spontaneous dissection of a LIMA graft in a patient with ACS.
Why the study?
Spontaneous dissection of the LIMA graft years after CABG is a rare cause of ACS, with limited reports in the literature outside of catheter-based interventions.
Case Report (n=1)
Spontaneous LIMA graft dissection is a rare but critical differential in post-CABG patients presenting with ACS, and IVUS is instrumental for diagnosis.
Consider spontaneous LIMA graft dissection in post-CABG ACS; case report leaves open incidence and management strategies.
BACKGROUND: Spontaneous dissection of the left internal mammary artery (LIMA), many years after coronary artery bypass grafting (CABG), is a rare cause of acute coronary syndrome (ACS). Most cases are associated with catheter-based interventions, with limited reports in the literature of spontaneous events. CASE SUMMARY: A 65 year-old woman with a remote history of CABG presented with acute left-sided chest tightness after intense physical exertion and emotional stress on the day of a family funeral. Coronary angiography revealed a spontaneous dissection of a LIMA graft, which was confirmed by intravascular ultrasound (IVUS), which demonstrated dissection flaps and an intramural hematoma. DISCUSSION: A spontaneous dissection of a LIMA graft is a rare but critical differential in post-CABG patients presenting with ACS. IVUS is instrumental in confirming the diagnosis and guiding management. TAKE-HOME MESSAGES: Spontaneous LIMA graft dissection is considered in post-CABG ACS presentations. IVUS is a key tool for diagnosis and treatment planning.
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Moussad et al. (2026) conducted a case report in Acute coronary syndrome secondary to spontaneous dissection of a left internal mammary artery graft (n=1). Intravascular ultrasound (IVUS) was evaluated on Diagnosis of spontaneous dissection of a LIMA graft. Intravascular ultrasound successfully confirmed the diagnosis of a rare spontaneous dissection of a left internal mammary artery graft in a patient presenting with acute coronary syndrome.
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