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Right ventricular rupture after coronary surgery

S P Barnard1, P A Kitching, E N Kulatilake

  • 1Department of Cardiac Surgery, University Hospital of Wales, Cardiff, UK.

Cardiovascular Surgery (London, England)
|December 1, 1994
PubMed
Summary
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A 70-year-old woman experienced fatal right ventricular rupture after coronary surgery due to fatty infiltration of the myocardium. This case highlights the critical role of myocardial composition in surgical outcomes.

Area of Science:

  • Cardiovascular Pathology
  • Surgical Complications
  • Cardiac Histology

Background:

  • Coronary artery bypass grafting (CABG) is a common surgical procedure.
  • Myocardial health is crucial for successful surgical outcomes.
  • Fatty infiltration of the myocardium is a recognized, though uncommon, pathological finding.

Observation:

  • A 70-year-old female patient underwent uneventful coronary surgery.
  • The patient experienced a fatal right ventricular rupture 12 hours post-operatively.
  • Post-mortem examination identified the rupture site within an area of significant fatty infiltration.

Findings:

  • The myocardial tissue at the rupture site was extensively replaced by adipocytes (fat cells).
  • Histological analysis confirmed severe fatty infiltration as the underlying pathology.

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  • This pathological finding directly correlated with the site of ventricular rupture.

    • Implications:

    • Fatty infiltration of the myocardium may represent a critical risk factor for ventricular rupture after cardiac surgery.
    • Pre-operative assessment of myocardial composition could potentially identify at-risk patients.
    • Further research into the prevalence and clinical significance of myocardial steatosis in cardiac surgery patients is warranted.