title: Spontaneous atrioventricular groove disruption during off-pump coronary artery bypass grafting.
abstract: 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.
authors.affiliation: Department of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, Missouri 63110, USA. lawtonj@msnotes.wustl.edu
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Lawton
authors.forename: Seema P
authors.initials: SP
authors.lastname: Deshpande
authors.forename: Paul B
authors.initials: PB
authors.lastname: Zanaboni
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Damiano
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D001120:Arginine / Q000031:analogs & derivatives; D002315:Cardiopulmonary Bypass; D047549:Coronary Artery Bypass, Off-Pump; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery; D004630:Emergencies; D017809:Fatal Outcome; D005260:Female; D006335:Heart Injuries / Q000209:etiology / Q000601:surgery*; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D007387:Internal Mammary-Coronary Artery Anastomosis; D007431:Intraoperative Complications / Q000209:etiology / Q000601:surgery*; D008943:Mitral Valve / Q000601:surgery; D009203:Myocardial Infarction / Q000209:etiology; D010875:Pipecolic Acids / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology; D012422:Rupture, Spontaneous; D013449:Sulfonamides; D013536:Suture Techniques; D013921:Thrombocytopenia / Q000139:chemically induced / Q000150:complications; D013923:Thromboembolism / Q000209:etiology
chemical_list: D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban