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Henry Ford Health System


Introduction: Iatrogenic injury of coronary arteries can complicate mitral valve replacement or repair. Direct injury to the circumflex coronary artery can occur due to the proximity of these vessels to the mitral valve. Acute injury of the right coronary artery on the other hand is seen during tricuspid valve repairs and is almost never seen with mitral valve surgery given its distance from the mitral valve.

Case: We describe an interesting case of minimally invasive mitral valve repair which was complicated by intraoperative right coronary artery occlusion. It was managed by angiography and percutaneous intervention.

Conclusion: While myocardial infarctions are rare in patients undergoing valvular surgery with normal preoperative coronary angiography, it must be suspected in patients with difficulty weaning from cardiopulmonary bypass and sudden reductions in cardiac function. In minimally invasive procedures with thoracotomy incisions, intraoperative angiography can be an indispensable tool. Swift intervention for revascularization and the use of postoperative cardiac assist devices can lead to favorable outcomes.

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Minimally Invasive Mitral Valve Repair Complicated By Intraoperative Right Coronary Artery Occlusion