Kinking of Right Coronary Artery as a Complication in Pulmonary and Tricuspid Valve Replacement

J INVASIVE CARDIOL 2018;30(3):E25.

Key words: cardiac imaging, kinking, coronary artery, complication of TAVR, CCTA

A 47-year-old patient with severe tricuspid regurgitation and pulmonary regurgitation was electively admitted for tricuspid valve and pulmonary valve replacement surgery. The preoperation cardiac computed tomography angiography revealed no significant coronary artery disease (mild plaque disease in the mid right coronary artery) (Figure 1A). Post operation, the patient failed to come off bypass, with electrocardiographic changes suggestive of acute myocardial ischemia. Urgent angiography revealed kinking in the distal part of the right coronary artery causing significant stenosis (Figure 1B). The lesion was treated by stenting, with good angiographic result (Figure 1C).

From the Royal Brompton and Harefield Trust, London, United Kingdom.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

Manuscript accepted July 3, 2017. 

Address for correspondence: Osama Samara, MD, Royal Brompton and Harefield Trust, 1 Manresa Rd, Chelsea, London SW3 6LR, United Kingdom. Email: o.samara@rbht.nhs.uk