Abstract
A 70-year-old man with severe symptomatic functional mitral valve regurgitation underwent successful mitral valve repair combined with tricuspid valve ring annuloplasty. Pre-operative coronary angiography (CAG) showed no significant stenosis. One-and-a-half years later, the patient presented with an acute exacerbation of heart failure. Repeat CAG demonstrated tight stenosis in the right coronary artery (RCA) with arterial kinking that corresponded to the same point as the stenosis where the RCA is the closest to the tricuspid valve ring. The new lesion probably occurred as a consequence of the tricuspid valve ring annuloplasty.
Similar content being viewed by others
References
Bonow RO, Carabello B, de Leon AC, Edmunds LH Jr, Fedderly BJ, Freed MD, Gaasch WH, McKay CR, Nishimura RA, O’Gara PT, O’Rourke RA, Rahimtoola SH, Ritchie JL, Cheitlin MD, Eagle KA, Gardner TJ, Garson A Jr, Gibbons RJ, Russell RO, Ryan TJ, Smith SC Jr. ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). J Heart Valve Dis. 1998;7:672–707.
Tang GH, David TE, Singh SK, Maganti MD, Armstrong S, Borger MA. Tricuspid valve repair with an annuloplasty ring results in improved long-term outcomes. Circulation. 2006;114:I577–81.
Diez-Villanueva P, Gutierrez-Ibanes E, Cuerpo-Caballero GP, Sanz-Ruiz R, Abeytua M, Soriano J, Sarnago F, Elizaga J, Gonzalez-Pinto A, Fernandez-Aviles F. Direct injury to right coronary artery in patients undergoing tricuspid annuloplasty. Ann Thorac Surg. 2014;97:1300–5.
Calafiore AM, Iaco AL, Bartoloni G, Di Mauro M. Right coronary occlusion during tricuspid band annuloplasty. J Thorac Cardiovasc Surg. 2009;138:1443–4.
Goldhammer J, Clark Hargrove W 3rd, Vernick WJ. Right coronary artery occlusion after tricuspid ring annuloplasty. J Cardiothorac Vasc Anesth. 2015;29:1606–9.
Gonzalez-Santos JM, Arnaiz-Garcia ME, Sastre-Rincon JA, Bueno-Codoner ME, Dalmau-Sorli MJ, Arevalo-Abascal A, Lopez-Rodriguez J, Diego-Nieto A. Acute right coronary artery occlusion after tricuspid valve ring annuloplasty. Ann Thorac Surg. 2015;99:2213–6.
Casquero E, Duran D, Asorey V, Casais R. Coronary artery spasm after mitral and tricuspid annuloplasty. Eur J Cardiothorac Surg. 2009;36:191.
Patel N, Cuculi F, Banning AP. Two rings too tight: sequential emergency PCI for hemodynamic and arrhythmic complications of mitral and tricuspid valve repair. Catheter Cardiovasc Interv. 2014;83:E73–6.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Tsuchida, K., Nishida, K., Oda, H. et al. Right coronary artery stenosis associated with tricuspid valve ring annuloplasty. Cardiovasc Interv and Ther 32, 420–424 (2017). https://doi.org/10.1007/s12928-016-0449-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12928-016-0449-2