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CASE SERIES
Year : 2020  |  Volume : 7  |  Issue : 3  |  Page : 313-317

Acute coronary disruption after Bentall’s procedure: outcome and the role of emergency coronary angiography


King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Correspondence Address:
MD,PhD Mohamed Laimoud
King Faisal Specialist Hospital and Research Center, Heart Center P.O. Box 3354, Riyadh 11211
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_47_19

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Coronary ostial stenosis is a rare but fatal consequence of aortic root surgery. Clinical presentations can include ventricular arrhythmias, acute coronary syndromes, congestive heart failure, or sudden death. Three interesting cases of acute coronary disruption after Bentall’s procedure were presented, with each case having a different outcome. The first case was a 56-year-old male patient admitted for elective Bentall’s procedure and developed inferoposterior STEMI complicated with ventricular fibrillation. After resuscitation, emergency percutaneous coronary intervention (PCI) and stenting of right coronary artery were performed successfully. The second case was a 39-year-old female patient admitted for Bentall’s procedure and was complicated with ventricular tachycardia with hemodynamic collapse necessitating venoarterial extracorporeal membrane oxygenation and emergency PCI to the left main coronary artery. The third case was a 41-year-old woman admitted for Bentall’s procedure and was complicated with fatal ventricular arrhythmias. After venoarterial extracorporeal membrane oxygenation and coronary angiography, emergency coronary artery bypass graft was done. Conclusion: Acute coronary ostial stenosis may occur after aortic root surgery and this complication may be life threatening and may lead to myocardial infarction or fatal ventricular arrhythmia. PCI with stenting is safe and effective after aortic root surgery and is an efficient alternative to coronary artery bypass graft.


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