Zhu M, Tang MM, Zhou RH. Refractory ventricular fibrillation caused by coronary insufficiency after Bentall procedure: A case report. World J Clin Cases 2025; 13(23): 106886 [DOI: 10.12998/wjcc.v13.i23.106886]
Corresponding Author of This Article
Rong-Hua Zhou, MD, Full Professor, Professor, Department of Anesthesiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. wr.zhou@hotmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2025; 13(23): 106886 Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.106886
Refractory ventricular fibrillation caused by coronary insufficiency after Bentall procedure: A case report
Min Zhu, Miao-Miao Tang, Rong-Hua Zhou
Min Zhu, Miao-Miao Tang, Rong-Hua Zhou, Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Tang MM collected the patient's clinical data, Zhu M drafted the manuscript, and Zhou RH contributed additional information and critically reviewed the final version of the manuscript.
Informed consent statement: Informed consent was obtained to publish this case report.
Conflict-of-interest statement: No potential conflicts of interest were reported by the authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rong-Hua Zhou, MD, Full Professor, Professor, Department of Anesthesiology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu 610041, Sichuan Province, China. wr.zhou@hotmail.com
Received: March 11, 2025 Revised: March 31, 2025 Accepted: May 7, 2025 Published online: August 16, 2025 Processing time: 86 Days and 15.7 Hours
Abstract
BACKGROUND
In open heart surgery requiring cardiopulmonary bypass (CPB), ventricular fibrillation (VF) is common, but refractory recurrent VF is uncommon but perilous.
CASE SUMMARY
This article reports a 58-year-old male patient with an ascending aortic aneurysm who presented for a Bentall procedure and subsequently experienced multiple occurrences of unexplained VF after weaning from CPB. The recurrent episodes of VF in this case were felt to be related to coronary insufficiency after reconstruction of the aortic root. Coronary artery bypass grafting (CABG) of the proximal right coronary artery and the left anterior descending artery successfully resolved VF. Finally, this patient was safely transferred to the postoperative intensive care unit, and was discharged successfully after subsequent supportive treatment.
CONCLUSION
In aortic root replacement, coronary insufficiency is a potential cause of VF episodes and should be considered in the differential diagnosis. CABG is the sole effective treatment for VF caused by coronary insufficiency.
Core Tip: Refractory recurrent ventricular fibrillation (VF) is a severe ventricular arrhythmia in cardiac surgery. We present a rare case of refractory VF caused by coronary insufficiency during Bentall procedure. This report underscores the rarity and severity of coronary insufficiency following aortic root reconstruction. Additionally, we review causes and treatment of refractory VF in cardiac surgery and provide a clinical management protocol for refractory VF during cardiac surgery.
