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Michael A. Borger
Tirone E. David
Nicolas Doll
Friedrich W. Mohr
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Right arrow Coronary disease

Ann Thorac Surg 2005;79:693-696
© 2005 The Society of Thoracic Surgeons

Case report

Intraoperative Fracture of the Right Coronary Artery: Recognition and Management

Michael A. Borger, MD, PhD*,a, Tirone E. David, MDa, Nicolas Doll, MDb, Friedrich W. Mohr, MD, PhDb

a Division of Cardiovascular Surgery, Toronto General Hospital, University of Toronto, Toronto, Canada
b Clinic for Heart Surgery, Heart Center, University of Leipzig, Leipzig, Germany

Accepted for publication September 8, 2003.

* Address reprint requests to Dr Borger, Division of Cardiovascular Surgery, Toronto General Hospital, Room EN 13-217, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4
michael.borger{at}uhn.on.ca

We describe the recognition and management of two patients who developed intraoperative fracture of the right coronary artery (RCA). Both patients had a calcified RCA without a hemodynamically significant stenosis. Compression of the right atrioventricular groove during the surgical procedure resulted in fracture of the RCA, leading to ventricular arrhythmias and hemodynamic instability. Coronary bypass grafting without cardioplegic arrest was used for definitive diagnosis and treatment. Both patients made a rapid and uneventful recovery.






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Copyright © 2005 by The Society of Thoracic Surgeons.