Refractory ventricular fibrillation caused by coronary insufficiency after Bentall procedure: A case report

In open heart surgery requiring cardiopulmonary bypass (CPB), ventricular fibrillation (VF) is common, but refractory recurrent VF is uncommon but perilous.

This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB. The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root. Coronary artery bypass grafting (CABG) of the proximal right coronary artery and the left anterior descending artery successfully resolved VF. Finally, this patient was safely transferred to the postoperative intensive care unit, and was discharged successfully after subsequent supportive treatment.

In aortic root replacement, coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis. CABG is the sole effective treatment for VF caused by coronary insufficiency.