Spontaneous left main coronary artery dissection, possibly due to cystic medial necrosis found in the internal mammary arteries

Abstract

A 55-year-old male without previous medical history developed chest pain. Coronary catheterization showed left main coronary dissection. Coronary artery bypass grafting was performed using bilateral internal mammary arteries, which were very fragile. The specimens of the internal mammary arteries sent for pathology showed cystic medial necrosis.