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Updated: Jan 22, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Proximal Right Coronary Artery Stenosis Secondary to Surgical Suture After Aortic Root Replacement
Jack Hartnett1, Ramzi Ibrahim1, Mahmoud Abdelnabi1
1Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, Arizona, USA.
Background:
Coronary artery reimplantation during aortic root replacement can be complicated by coronary ostial stenosis. Although an uncommon complication, it can cause serious sequelae including acute coronary syndrome, ventricular failure, or ventricular arrhythmias, leading to sudden cardiac death.
Case Summary:
We present the case of a 39-year-old man with previously normal coronary arteries who underwent aortic root replacement with a mechanical valve and conduit for severe aortic regurgitation secondary to Takayasu arteritis-induced aortopathy. Coronary angiography performed 5 months after surgery for new inferior regional wall motion abnormalities showed proximal right coronary artery (RCA) stenosis. Optical coherence tomography (OCT) identified a suture through the lumen of the RCA as the cause of the stenosis. This was treated with cutting balloon dilatation followed by drug-eluting stent placement.
Discussion:
This is to our knowledge the first reported case of proximal RCA stenosis secondary to a suture visualized by OCT in a reimplanted coronary artery.
Take-Home Message:
OCT, a high-resolution intracoronary imaging modality, can help elucidate the etiology of stenosis of a reimplanted coronary artery.
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