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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
Authors:William Clifford Roberts  Brent Andrew Patterson  Jong Mi Ko  Rebecca Anne Sager  Jason Andrew Clark  Joseph Manuel Guileyardo
Affiliation:1. Baylor Heart and Vascular Institute, Baylor University Medical Center, Dallas, TX 75246, USA;2. Department of Pathology, Baylor University Medical Center, Dallas, TX 75246, USA;3. Department of Internal Medicine (Cardiology), Baylor University Medical Center, Dallas, TX 75246, USA;3. Experimental Surgery Unit, Department of Heart and Vessels, Careggi Hospital, Florence, Italy;2. Department of Critical Care Medicine and Surgery, University of Florence, Careggi Hospital, Florence, Italy;1. Institute of Cardiovascular Diseases of PLA, Xinqiao Hospital of the Third Military Medical University, Chongqing 400037, China;2. Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China;1. Department of Surgery, Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass;2. School of Veterinary Medicine, Federal University of Goias, Goiania, Brazil;3. Department of Surgery, Division of Cardiothoracic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI;1. Department of Medicine, University of Toronto, Toronto, Ontario, Canada;2. Department of Pathology, Toronto General Hospital/University Health Network, Toronto, Ontario, Canada;3. Department of Cardiology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada;4. Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada;1. Department of Internal Medicine, University of Texas Southwestern Medical Center;2. Cardiac Transplant Research Database, University of Alabama at Birmingham;3. Department of Internal Medicine, Temple University;4. Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center;5. Current address is Department of Internal Medicine, Baylor University Medical Center;6. Current address is Department of Internal Medicine, University of Pennsylvania;7. Current address is Lillehei Heart Institute, University of Minnesota Medical School
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.
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