Spontaneous Atrioventricular Groove Disruption During Off-Pump Coronary Artery Bypass Grafting

Atrioventricular groove disruption after aortic valve replacement

“…[1,2] One case report of AVG disruption following off pump coronary artery bypass graft was reported in literature. [3] AVG tear after isolated aortic valve replacement has not been reported before. We experienced AVG disruption following tissue aortic valve replacement.…”

“…Incipient or spontaneous AVG disruption occurs during manipulation of the heart during cardiac surgery. [3] These lead to increased left atrial pressure and volume. The tension is transmitted to vulnerable AVG resulting in tear.…”

“…[6] Another cause for AVG disruption is overzealous use of ionotropes leading to potential stress in susceptible myocardium. [3] AVG is a fibrocollagenous structure and weakened transitional between atrium and ventricle, only conduction zone provides muscular continuity. [7] Mechanism of disruption to AVG in every case is difficult to identify due to its anatomical position.…”

Aneurysms and Dissections

“…19-43). [102][103][104][105] There are three types of serious ventricular injury in this setting. [102][103][104][105] There are three types of serious ventricular injury in this setting.…”

“…19-44; also see Fig. [103][104][105] There is a risk of injury to the circumflex coronary artery and coronary sinus during repairs for type I ruptures, because these structures are intimately related to the atrioventricular groove (see Fig. Comprehensive echocardiographic evaluation can guide surgical decision making for extent of annular resection and annular repair.…”