Although most reports highlight the potential for coronary
artery stenosis in the months following valve surgery there are
few documented cases of intraoperative coronary embolism
causing circulatory collapse and requiring prompt treatment [5].
After Ethical Committee approval and after written consent
taken from the patient family for publication, we present a case of
acute intra operative left main coronary artery obstruction after
Aortic Valve Replacement (AVR) and its immediate management.
Case Presentation
41-year-old male patient known to be diabetic, hypertensive
and ex-smoker. The patient was presented by shortness of breath
on moderate exertion. Patient was subjected for routine work up
and investigations which revealed Lymphadenopathy in different
anatomical areas including mediastinal LN and Para aortic LN
and final diagnosis was pending based on thoracic LN biopsy to
be taken on time of cardiac surgery. Patient also diagnosed to
have moderate restrictive lung disease and hepatitis B positive
with liver impairment.
Trans thoracic echocardiography TTE revealed severe mitral
regurgitation, severe aortic regurgitation, and mild tricuspid
regurgitation. Coronary Angiography showed normal coronaries.