Beating heart myocardial revascularisation of a sudden cardiac death survivor with spontaneous coronary artery dissection: Pitfalls from diagnosis to surgery

Spontaneous coronary artery dissection is a rare clinical condition with a wide range of clinical presentations ranging from asymptomatic cases to life-threatening ventricular arrhythmias and sudden cardiac death. The exact pathophysiological mechanism has not been fully established yet. We would like to present a survivor of sudden cardiac death presenting with ventricular fibrillation due to spontaneous coronary artery dissection. The prompt evaluation, medical management, surgical myocardial revascularisation and value of off-pump coronary artery bypass surgery are discussed.