Right coronary artery dissection in a patient with redo aortic valve surgery

Aortic valve replacement is the gold standard of the surgical treatment of infective endocarditis of the aortic valve, it is often accompanied by complications that may develop into abscess formation of the annulus and engage the coronary arteries ostia in the process, causing dissection. However, with repeated interventions on the aortic valve such complications as trauma of perimembranous septum, damage of conduction system, left ventricular myocardial defects, dissection of the ostia of coronary arteries are inevitable, which are iatrogenic injuries and are related with the type of prosthesis and the patient's anatomical features. Our case shows how devastating complications may be, regardless of the standard therapy, and allows us to offer the most aggressive approach in patients with repeated intervention on the aortic valve. The aim of our report is to demonstrate the appearance and effective repair of right coronary artery ostium acute dissection in a patient after aortic valve replacement due to the mechanical prosthesis dysfunction.

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