Dissection of the left main coronary artery during percutaneous intervention: successful surgical management.

Coronary dissection during diagnostic catheterization presents a therapeutic challenge. Medical management or percutaneous intervention may be an option in a stable patient. Unstable patients should promptly undergo surgical revascularization. We report on a patient in whom dissection of the left main coronary artery, the left anterior descending artery, and a diagonal branch occurred during catheterization. Clear signs of myocardial ischemia indicated immediate surgery. Coronary artery bypass grafting was carried out within a very short time frame and the patient survived. This case demonstrates the value of an expeditious surgical treatment strategy.