Urgent myocardial revascularization for dissection of the left main coronary artery: a complication of coronary angiography.

Acute subintimal dissection of the left main coronary artery (LMCA) is a rare but devastating complication of selective coronary angiography. The compromise of the coronary blood flow to an extensive area of myocardium becomes clinically evident in most patients shortly after the injury. Three patients who had catheter-induced LMCA dissection were successfully managed with aorta-coronary artery bypass. We recommend that urgent myocardial revascularization using standard techniques should be carried out in all patients following this injury.