Coronary Artery Occlusion; the Night Mare Post AVR

Iatrogenic intra operative acute coronary artery obstruction is a rare and potentially fatal complication of valve surgery [1]. Sudden coronary spasm, embolization of calcium plaque, and surgical factors can induce acute coronary obstruction after AVR [2]. Initially described in 1967, following aortic valve surgery, it is now recognized that patients who develop myocardial ischemia postoperatively following valve surgery, should be investigated deeply to exclude this rare phenomenon as the cause of myocardial dysfunction [3]. Although most reports highlight the potential for coronary artery stenosis in the months following valve surgery there are few documented cases of intraoperative coronary embolism causing circulatory collapse and requiring prompt treatment [5]. After Ethical Committee approval and after written consent taken from the patient family for publication, we present a case of acute intra operative left main coronary artery obstruction after Aortic Valve Replacement (AVR) and its immediate management.