title: Unexpected thrombus migration obstructing the right coronary ostium after thoracic aorta graft replacement.
abstract: Unexpected and reversible causes of ventricular dysfunction requiring a prompt second surgical procedure to restore the cardiac function should always be sought before the initiation of positive inotropic support. We report a case of obstruction of the right coronary ostium by an organized thrombus that had migrated retrogradely from the false lumen of a dissected aortic aneurysm. The resultant ventricular dysfunction hindered separation from cardiopulmonary bypass. Prompt recognition was done by transesophageal echocardiography and a second surgical procedure was immediately performed to remove the thrombus before irreversible ventricular dysfunction occurred.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
authors.forename: Jae-Kwang
authors.initials: JK
authors.lastname: Shim
authors.forename: Young
authors.initials: Y
authors.lastname: Song
authors.forename: Taek-Yeon
authors.initials: TY
authors.lastname: Lee
authors.forename: Yoon-Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Young-Lan
authors.initials: YL
authors.lastname: Kwak
mesh_terms: D000784:Aortic Dissection / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D002315:Cardiopulmonary Bypass / Q000379:methods; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery*; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
keywords: right coronary artery; thoracic aorta surgery; thrombus