Acute right ventricular failure during aortic valvular operation due to mechanical problem in the right coronary artery

Acute Right Coronary Artery Embolus after Aortic Valve Surgery

“…[2][3][4][5] Myocardial ischemia secondary to a paradoxical embolus resulting from peripheral venous thrombus or after cardiac catheterization has also been reported. 1,6 In this case, the cause of the embolus was probably a thrombus that formed and migrated during a period of abnormal hemostasis. Management of this complication is usually by grafting the occluded vessel.…”

“…Indeed, coronary occlusion due to a mechanical problem is easier to diagnose because it usually manifests during surgery as failure to wean off cardiopulmonary bypass, and the right ventricle can be seen to be immobile and dilated. 1 Cardiopulmonary bypass should be re-instituted to evaluate the position of the valve and check the coronary ostia; the cause is often malpositioned leaflets obstructing the right coronary ostia or a deep stitch taking in the right coronary ostia from the annulus side. On the other hand, the diagnosis of a coronary embolus depends on certain factors such as the time of onset of ischemia and the type of embolus.…”