Massive acute infarction of the right ventricular wall without or only minimal infarction of the left ventricular wall after aortic valve replacement with or without simultaneous replacement of the ascending aorta

Roberts, William Clifford; Patterson, Brent Andrew; Ko, Jong Mi; Sager, Rebecca Anne; Clark, Jason Andrew; Guileyardo, Joseph Manuel

doi:10.1016/j.carpath.2008.12.011

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Volume 19, Issue 3 , Pages 187-190, May 2010

Massive acute infarction of the right ventricular wall without or only minimal infarction of the left ventricular wall after aortic valve replacement with or without simultaneous replacement of the ascending aorta

William Clifford Roberts
- Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX 75246, USA
- Department of Pathology, Baylor University Medical Center, Dallas, TX 75246, USA
- Department of Internal Medicine (Cardiology), Baylor University Medical Center, Dallas, TX 75246, USA
- Corresponding author. Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX 75246, USA. Tel.: +1 214 820 7911; fax: +1 214 820 7533.
Brent Andrew Patterson
- Department of Internal Medicine (Cardiology), Baylor University Medical Center, Dallas, TX 75246, USA
Jong Mi Ko
- Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX 75246, USA
Rebecca Anne Sager
- Department of Pathology, Baylor University Medical Center, Dallas, TX 75246, USA
Jason Andrew Clark
- Department of Pathology, Baylor University Medical Center, Dallas, TX 75246, USA
Joseph Manuel Guileyardo
- Department of Pathology, Baylor University Medical Center, Dallas, TX 75246, USA

Received 1 October 2008; received in revised form 17 November 2008; accepted 16 December 2008. published online 12 February 2009.

Abstract

Certain clinical and cardiac morphologic findings are presented in two men who developed massive right ventricular (RV) infarction with only minimal or no left ventricular infarction early after aortic valve replacement. The ostium of the right coronary artery was severely narrowed in one patient by the ring of the bioprosthesis, and in the other patient the right coronary artery was completely severed at the time of valve replacement without insertion of a coronary bypass conduit. Such massive infarction of the RV free wall has not been reported previously.

Keywords: Acute infarction, Right ventricular wall, Left ventricular wall, Aortic valve replacement, Ascending aorta