Multivessel Woven Coronary Artery Disease

Abstract

Woven coronary disease is a rare pathology with unknown etiology. Although initially considered benign, recent publications report myocardial ischemia caused by the affected vessel. Since most patients are asymptomatic, long-term follow-up to understand its behavior is mandatory. We report a multivessel woven disease case with documented ischemia that was submitted to coronary artery bypass grafting and remained asymptomatic for two years of follow-up.

Keywords: Coronary Anomaly; Coronary Artery Bypass Grafts; Coronary Artery Disease; Woven Coronary Disease.

Fig. 1

Angiotomography - Multivessel woven coronary artery disease. A) Woven coronary disease affecting LAD on its proximal and middle thirds, proximal Dg. B) LAD affected on its proximal third and total occlusion of the CX. C) RCA affected on its middle and distal thirds and LAD af fected on its middle third. CX=circumflex artery; Dg=diagonal branch of the LAD; LAD=left anterior descending artery; RCA=right coronary artery.

Fig. 2

Coronary Angiography - Multivessel woven coronary artery disease. A) LAD affected on its proximal third. CX occluded proximally with collateral filling with the same woven aspect. B) LAD with Swiss cheese aspect on its proximal and middle thirds with the classical "figure of 8". Dg branch affected on its origin. C) RCA affected at the middle and distal thirds; image associated with Swiss cheese aspect. CX=circumflex artery; Dg=diagonal branch of the LAD; LAD=left anterior descending artery; RCA=right coronary artery.

Fig. 3

Surgical view of the woven coronary disease. A) LAD and Dg after pericardium opening. B) LIMA sequential to LAD and Dg. Dg=diagonal branch of the LAD; LAD=left anterior descending artery; LIMA=left internal mammary artery.