We report a case of spontaneous coronary artery rupture (SCAR) 3 months after descending aortic replacement. Cardiac tamponade was confirmed at first by using echocardiography following emergency pericardial centesis. The patient was denied aortic dissection by computed tomography, thereafter diagnosed as SCAR with selective angiography, which revealed a leakage from the left circumflex branch. The patient underwent successful rupture site isolation by bilateral ligation and distal revascularization with aortocoronary bypass with saphenous vein graft.

No abstract