Complete healing of spontaneous coronary artery dissection extending from the left main trunk to the left anterior descending and the left circumflex artery.

Spontaneous coronary artery dissection (SCAD) is defined as a spontaneous separation of the coronary artery wall that is not iatrogenic or related to trauma and usually affects young women. We describe a 65-year-old woman who presented with SCAD extending from the left main trunk involving the left anterior descending artery and the left circumflex artery, and coronary artery bypass graft surgery was performed to treat the dissection. Coronary angiography performed 3 months later, showed complete angiographic healing. A conservative management strategy is known to be associated with spontaneous angiographic healing in patients with SCAD who are hemodynamically stable. Healthcare providers should consider SCAD among the differential diagnoses in patients presenting with acute coronary syndrome, particularly in women. Further studies are needed to establish an optimal management strategy for SCAD.

Objective: Spontaneous coronary artery dissection (SCAD) might be a cause of acute coronary syndrome not only in younger but also in older women. Even if the area of the dissection is broad, healing can be expected in future. Therefore, it is important to select between conservative and invasive therapy such as percutaneous coronary intervention or coronary artery bypass graft including selection of graft, i.e. saphenous vein graft and radial arteries, and internal mammalian arteries.>.