CORONARY-ARTERY PROBLEMS DURING HOMOGRAFT AORTIC-VALVE REPLACEMENT - ROLE OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY

We describe 2 cases in which intraoperative transesophageal echocardio graphy detected complications related to the proximal coronary arterie s during homograft aortic valve and root replacement. In both cases, c ardiopulmonary bypass could not be discontinued despite the use of lar ge doses of inotropic drugs. Transesophageal echocardiography demonstr ated aliasing on color flow mapping in the left main coronary artery i n 1 case and proximal right coronary artery in the other, along with s everely depressed left ventricular anterior wall and right ventricular function, respectively. Coronary artery bypass grafting was performed in both cases, and the outcome was successful. (C) 1997 by The Societ y of Thoracic Surgeons.