Acute Right Coronary Ostial Stenosis during Aortic Valve Replacement

We report a rare case of acute right coronary artery stenosisdeveloping in a patient undergoing aortic valve replacement. wepresent a case report with a brief overview of the literature relatingto coronary artery occlusion associated with cardiac valve surgery –the theories and treatments are discussed. a 85 year-old female wasadmitted under the care of the cardiothoracic team with signsand symptoms of heart failure. investigations, including cardiacechocardiography and coronary angiography, indicated a criticalaortic valve stenosis. intraoperative right ventricular failure ensuedpost aortic valve replacement. subsequent investigations revealedan acute occlusion of the proximal right coronary artery withresultant absence of distal flow supplying the right ventricle. animmediate right coronary artery bypass procedure was performedwith resolution of the right ventricular failure. subsequent weaningoff cardiopulmonary bypass was uneventful and the patientcontinued to make excellent recovery in the postoperative phase.to our knowledge this is one of the few documented cases ofintraoperative acute coronary artery occlusion developing duringvalve surgery. however, surgeons should be aware of the potentialfor acute occlusion so that early recognition and rapid interventioncan be instituted.