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Ann Thorac Surg 2005;79:339-341
© 2005 The Society of Thoracic Surgeons

Case report

Spontaneous Atrioventricular Groove Disruption During Off-Pump Coronary Artery Bypass Grafting

Jennifer S. Lawton, MD*,a, Seema P. Deshpande, MDb, Paul B. Zanaboni, MDb, Ralph J. Damiano, Jr, MDa

a Department of Cardiothoracic Surgery, St. Louis, Missouri, USA
b Department of Cardiothoracic Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, USA

Accepted for publication August 19, 2003.

* Address reprint requests to Dr Lawton, Division of Cardiothoracic Surgery, Washington University in St. Louis, One Barnes Jewish Hospital Plaza, Queeny Tower, Ste 3108, St. Louis, MO, USA 63110
lawtonj{at}msnotes.wustl.edu

Atrioventricular groove tear or disruption is a disastrous and technically challenging complication after mitral valve replacement surgery. This report details the untimely spontaneous occurrence of an atrioventricular tear during manipulation of the heart for off-pump coronary artery bypass grafting and its successful repair. Significant distortion of the mitral annulus and elevation of pulmonary artery pressures in the beating heart likely contributed to the spontaneous tear.




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