Massive acute infarction of the right ventricular wall without or only minimal infarction of the left ventricular wall after aortic valve replacement with or without simultaneous replacement of the ascending aorta

Certain clinical and cardiac morphologic findings are presented in two men who developed massive right ventricular (RV) infarction with only minimal or no left ventricular infarction early after aortic valve replacement. The ostium of the right coronary artery was severely narrowed in one patient by the ring of the bioprosthesis, and in the other patient the right coronary artery was completely severed at the time of valve replacement without insertion of a coronary bypass conduit. Such massive infarction of the RV free wall has not been reported previously.