title: Intraoperative fracture of the right coronary artery: recognition and management.
abstract: 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.
authors.affiliation: Division of Cardiovascular Surgery, Toronto General Hospital, University of Toronto, Toronto, Canada. michael.borger@uhn.on.ca
authors.forename: Michael A
authors.initials: MA
authors.lastname: Borger
authors.forename: Tirone E
authors.initials: TE
authors.lastname: David
authors.forename: Nicolas
authors.initials: N
authors.lastname: Doll
authors.forename: Friedrich W
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D001011:Aorta; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis; D001145:Arrhythmias, Cardiac / Q000209:etiology; D002114:Calcinosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002275:Carcinoid Heart Disease / Q000150:complications; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000601:surgery; D012501:Saphenous Vein / Q000637:transplantation