ABSTRACT
Although the incidence is very low, acute mechanical obstruction of the right coronary artery may occur as a cause of right ventricular failure during aortic surgery. In a 67-year-old woman with severe aortic regurgitation, acute right ventricular failure was noticed at the end of cardiopulmonary bypass weaning after an aortic valve replacement with a Hancock II 19 mm bioprosthesis. We suspected mechanical obstruction of the right coronary artery and consequent coronary artery bypass graft to the right coronary artery with right internal mammary artery was performed with success in weaning the bypass. On the postoperative 9th day, the right coronary angiogram revealed obstruction at proximal right coronary artery by plaque emboli. We herein report a clinical case in which the acute right ventricular failure occurred due to mechanical obstruction of the right coronary artery was recovered by coronary artery bypass graft to the right coronary artery.