Iatrogenic occlusion of the right coronary artery (RCA) is a rare complication after tricuspid valve surgery. We review the case of a 74-year-old female who presented for mitral and tricuspid valve annuloplasty. Unanticipated postcardiopulmonary bypass biventricular hypokinesis was encountered, necessitating extracorporeal support. Emergent coronary angiography demonstrated near-complete RCA occlusion from a taut periarterial suture near the RCA. Deployment of a drug-eluting stent restored normal flow, and the patient made a full recovery. Although an exceedingly rare complication, iatrogenic RCA injury after tricuspid valve operations should be considered in the setting of unexpected ventricular compromise.
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