[Significance of intramural vascular injuries in myocardial revascularization. A case report].

The authors report the case of 59 year-old hypertensive woman, suffering from angina pectoris, who died 24 hours after coronary by pass surgery due to cardiogenic shock. Autopsy revealed a small recent postero-lateral infarction. The venous by pass, however, were inconspicuous. Histologic examination showed extensive microarteriopathy with stenosing intimal fibro-elastosis and hyperplasia of the media, affecting 73% of the vessels with a diameter greater than 150 micra. The authors believe that the diffuse microangiopathy could have affected the myocardial reperfusion, and participated of the mechanical dysfunction.