Ventricular Fibrillation and Myocardial Depression Following Pulmonary Valve Replacement in Tetralogy of Fallot With an Intramural Coronary Artery and Coronary Artery Compression by Chest Tube. Issue 4 (July 2020)

• Record Type: Journal Article
• Authors: Ahmed, Mubbasheer; Thompson, Nathan E.; Foerster, Susan R.; Frommelt, Michele A.; Mitchell, Michael E.; Scott, John P.
• Is Part Of: World journal for pediatric & congenital heart surgery. Volume 11:Issue 4(2020)
• Page Start: NP77
• Page End: NP79
• Publication Date: 2020-07
• Subjects: coronary artery imaging -- congenital heart surgery -- arrhythmia -- surgery complications; Pediatric cardiology -- Periodicals; Congenital heart disease in children -- Periodicals; Heart -- Abnormalities -- Surgery -- Periodicals; Heart -- Surgery -- Periodicals; Heart Defects, Congenital -- surgery -- Periodicals; Cardiac Surgical Procedures -- Periodicals; Child -- Periodicals; Adult -- Periodicals; 618.9212
• DOI: 10.1177/2150135117716421
• Languages: English
• ISSNs: 2150-1351

Abstract

We describe the case of a 10-year-old male with a history of repaired Tetralogy of Fallot and known intramural right coronary artery (RCA) who presented for bioprosthetic pulmonary valve replacement. The operation was complicated by postoperative ventricular fibrillation arrest. Selective coronary angiography revealed external compression of the mid-RCA by a mediastinal chest tube that improved immediately upon removal of the tube. Ultimately, the patient required additional unroofing of the intramural coronary for full recovery. This case highlights the need to thoroughly investigate malignant ventricular dysrhythmias following pediatric cardiac surgery and to rule out coronary insufficiency, which may be due to both extrinsic and/or intrinsic lesions.