Right ventricular performance at rest and during stress with chronic proximal occlusion of the right coronary artery

Abstract OnBehalf Cornwall A term neonate with poor condition at birth was noted to be markedly bradycardic when crying. ECG showed first degree heart block. Echocardiogram demonstrated poor bi-ventricular function. He was treated for Hypoxic ischemic encephalopathy (HIE). In the next few hours he developed short episodes of ventricular tachycardia with left bundle branch block and non-conducted P waves suggesting an origin of tachycardia from the right ventricle. His repeat ECHO suggested that he had right ventricular infarction due to a very rare finding of intermittent occlusion of the origin of the right coronary artery by an echogenic mass. He was transferred for emergency cardiac surgery to remove a clot of 1.6cm, occluding the right coronary artery. Histology findings were in keeping with a thrombus. Thrombophilia screen for both parents and infant were negative. MRI Brain did not show evidence of HIE suggesting his poor condition at birth was secondary to intermittent coronary ischemia. Discussion: Myocardial infarction (MI) in neonates is a rarely encountered and potentially life-threatening condition, with mortality rate as high as 90%. We present one of the first reported cases of successful surgical management of an acute right coronary artery thrombosis after an early diagnosis. The cause of thrombosis remains unclear in our patient. They were born in poor condition with initial pH 6.9 and lactate of 10, but with a structurally normal heart and negative thrombophilia screen. Perinatal asphyxia is a potential cause; however there is doubt that this may be a symptom rather than cause of the right coronary artery occlusion. Early diagnosis was key in management after a high level of clinical suspicion. He made significant recovery with near normal RV function, and is currently on captopril and carvedilol post-surgery. This is one of the first cases to document near full return of cardiac function following ischaemia to the right ventricle Abstract 478 Figure. 5

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Tetralogy of Fallot correction with transannular patch reconstruction in a patient with an anomalous right coronary artery and an unusual course of the right ventricular branch

Indian Journal of Thoracic and Cardiovascular Surgery ◽

10.1007/s12055-020-01074-0 ◽

2020 ◽

Author(s):

Sabrina Anne Gonzalez ◽

Sivakumar Sivalingam

Keyword(s):

Coronary Artery ◽

Right Ventricular ◽

Tetralogy Of Fallot ◽

Right Coronary Artery ◽

Transannular Patch ◽

The Right

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Phasic characteristics of arterial inflow and venous outflow of right ventricular myocardium in dogs

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1992.262.5.h1422 ◽

1992 ◽

Vol 262 (5) ◽

pp. H1422-H1427 ◽

Cited By ~ 2

Author(s):

O. Hiramatsu ◽

A. Kimura ◽

T. Yada ◽

T. Yamamoto ◽

Y. Ogasawara ◽

...

Keyword(s):

Coronary Artery ◽

Right Ventricular ◽

Right Coronary Artery ◽

Pulmonary Stenosis ◽

Systolic Pressure ◽

Laser Doppler Velocimeter ◽

Venous Outflow ◽

Coronary Veins ◽

Arterial Inflow ◽

The Right

To clarify the characteristics and causes of phasic blood flow in coronary circulation of the right ventricle we measured blood velocities in peripheral portions of the right coronary artery and vein in dogs under three conditions: control, transient pulmonary stenosis, and isoproterenol administration. An optical fiber sensor of a laser Doppler velocimeter was fixed onto the vessels (150-500 microns OD) with cyanoacrylate. The phasic pattern of distal arterial velocity was compared with the proximal velocity in the right coronary artery measured with an ultrasound pulsed Doppler velocimeter. Systolic-to-total velocity area ratio in the small epicardial artery [0.38 +/- 0.03 (SE)] was found to be smaller than in the large epicardial artery (0.51 +/- 0.02, P less than 0.01), indicating a capacitive filling of the epicardial artery during systole. The velocity waveform in small right coronary veins was predominantly systolic; i.e., it increased with a rise of right ventricular pressure and decreased with right ventricular relaxation. Comparison of the waveforms during isoproterenol infusion and pulmonary stenosis indicates that contraction of the ventricle is more important than right ventricular systolic pressure in retarding arterial inflow and accelerating venous outflow.

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A case of right ventricular infarction due to acute Type A aortic dissection with anomalous aortic origin of the right coronary artery from the left sinus of Valsalva

10.22541/au.163256941.11675678/v1 ◽

2021 ◽

Author(s):

Yojiro Machii ◽

Naohiro Shimada ◽

Takashi Okamoto ◽

Masashi Tanaka

Keyword(s):

Coronary Artery ◽

Aortic Dissection ◽

Right Ventricular ◽

Right Coronary Artery ◽

Acute Type ◽

Sinus Of Valsalva ◽

Right Ventricular Infarction ◽

Ventricular Infarction ◽

The Right ◽

Left Sinus Of Valsalva

Anomalous aortic origin of a coronary artery from the opposite sinus is a rare congenital condition that can cause sudden death in young people. When it is associated with acute aortic dissection, acute myocardial infarction can occur due to enlargement of the sinus of Valsalva. We report the case of a 71-year-old man with anomalous origin of the right coronary artery from the left sinus of Valsalva, who developed right ventricular infarction due to the compression of the right coronary artery between the aorta and pulmonary artery trunk.

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