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Ann Thorac Surg 2009;87:1946-1948. doi:10.1016/j.athoracsur.2008.11.009
© 2009 The Society of Thoracic Surgeons
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Fabien Doguet
François Bouchart
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Right arrow Coronary disease

Case Reports

Coronary Artery Dissection After Surgical Cryoablation Procedure

Fabien Doguet, MDa,*, Vincent Le Guillou, MDa, Pierre Yves Litzler, MD, PhDa, François Bouchart, MDa, Catherine Nafeh-Bizet, MDa, Alain Cribier, MDb, Jean Paul Bessou, MDa

a Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital, Rouen, France
b Department of Cardiology, Rouen University Hospital, Rouen, France

Accepted for publication November 3, 2008.

* Address correspondence to Dr Doguet, Department of Thoracic and Cardiovascular Surgery, Rouen University Hospital, 1, rue de Germont, Rouen, 76000, France (Email: fabien.doguet{at}chu-rouen.fr).

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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