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Abstract
To date, the surgical management for this condition relies on various techniques, which include coronary artery bypass grafting (CABG) and repair coronary vessels. Among them, 36 patients (36/371, 10%; 25 men and 11 women; mean age: 49.7 +- 13.5 years) suffered coronary malperfusion due to dissection of coronary ostia, they had electrocardiographic signs of myocardial ischemia (including new ST-segment elevation more than 0.1 mV and/or Q waves). According to the Neri's definition of coronary malperfusion in aortic dissection,[2] we differentiated among three types of lesions based upon operative findings: type A (n = 23), ostial dissection is defined as a disruption of the inner layer limited to the area of the coronary ostium without disrupting coronary vessel; type B (n = 8), dissection with a coronary false channel; and type C (n = 5), circumferential detachment with an inner cylinder intussusception. In the case of type B coronary artery dissection, the coronary artery was transected in a nondiseased zone, and short graft was performed with saphenous vein or polytetrafluoroethylene artificial graft (Gore-Tex, W.L. Gore&Associates, Inc., Flagstaff, Arizona, USA) by a continuous 7-0 polypropylene suture [Figure 1]; in the case of type C coronary artery dissection, the proximal coronary artery was ligated, then CABG was performed using saphenous vein graft [Table 1]. Postoperative hemorrhage necessitating reoperation developed in two patients. [...]one patient suffered acute renal failure requiring temporary hemodialysis. [1],[2] Although the angiography is the gold standard to evaluate the coronary anatomy and to discriminate acute coronary artery disease caused by...