[Iatrogenic occlusion of the anterior descending branch of the left coronary artery. Description of a case]. / Occlusione iatrogenica del ramo discendente anteriore della coronaria sinistra. Descrizione di un caso.

A 27 years old man was admitted in our Institute for exertion dyspnea, palpitation and a single syncopal attack; five months before admission he was subjected to thoracotomy for pericardial and myocardial haemostatic suture because of a slash. Clinical, phonocardiographic and echocardiographic data suggested diagnosis of combined aortic stenosis and aortic regurgitation. An anterior myocardial necrosis was in ECG and VCG, Cardiac catheterization confirmed previous report. Coronary arteriography showed total occlusion of left anterior descending artery soon after the second diagonal branch. Right coronary was undamaged. Furthermore left ventricular angiocardiography showed a changed ventricular function. The Authors point out the iatrogenic cause of the coronary occlusion; it was due to the inclusion of left anterior descending artery in the surgical myocardial and pericardial haemostatic suture and/or post-traumatic fibrosis. It is necessary to watch over the patient as the changed ventricular function can develop in an aneurismatic area.