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Iatrogenic right coronary artery stenosis resulting from surgical tricuspid valve replacement
Author(s) -
Morrissy Stephen J.,
Atkins Broadus Zane,
Rogers Jason H.
Publication year - 2014
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25623
Subject(s) - medicine , tricuspid valve , right coronary artery , cardiology , valve replacement , surgery , tricuspid stenosis , stenosis , myocardial infarction , coronary angiography
Iatrogenic injury to the right coronary artery (RCA) is a rare complication of tricuspid valve surgery. We herein describe the first‐ever report of RCA injury related to tricuspid valve replacement surgery. A 38‐year‐old man with recurrent tricuspid endocarditis underwent redo tricuspid valve replacement by means of a minimally invasive right thoracotomy with a 32‐mm St. Jude bioprosthetic valve. His post‐operative course was complicated by pulseless ventricular tachycardia requiring CPR and defibrillation. Cardiac catheterization revealed a “kinked” stenotic distal RCA. The lesion was noted to be flow limiting by fractional flow reserve and was treated with two everolimus‐eluting stents. The RCA runs in the atrioventricular groove and is susceptible to injury especially in the region of the posterior leaflet of the tricuspid valve, where the relationship of the tricuspid annulus to the RCA is most intimate. Repair of surgically induced coronary stenosis can be accomplished with percutaneous intervention. © 2014 Wiley Periodicals, Inc.