A Case of Acute Left Main Coronary Obstruction Following Transcatheter Aortic Valve Implantation

Dimitrova, Iva N.; Trendafilova, D.; Simeonov, П.

doi:10.7759/cureus.1951

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Coronary artery occlusion tends to involve the left coronary artery more frequently than the RCA because of the naturally higher ostial takeoff of the RCA. 9 Coronary obstruction during TAVI for native aortic valve stenosis can occur due to anatomical or procedural-related factors. The established anatomical risk factors for coronary occlusion during TAVI in severe native aortic valve stenosis include the low origin of the coronary arteries, narrow sinus of Valsalva, calcium burden, and location of calcium on the cusp.…”

Section: Discussionmentioning

confidence: 99%

“…5 Preprocedural assessment of aortic valve anatomy using multidetector computed tomography is a crucial step to minimize and anticipate the potential risk of complications including aortic annulus rupture, perivalvular leak, and coronary occlusion. 9,12,13 Eventually, for patients who are deemed at considerable risk for coronary occlusion pre-TAVI CTA evaluation, transcatheter techniques such as coronary protection with a standard guidewire, placing a snorkel stent, or per performing BASILICA procedure is advisable to prevent and treat the potential occlusion. 14 Intraprocedural CO should be suspected in the presence of high-grade heart blocks, severe hypotension, lethal ventricular arrhythmias, or dynamic ST-segment changes.…”

Section: Discussionmentioning

confidence: 99%

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Coronary Artery Protection with Chimney Stent in High-Risk Case of Coronary Occlusion in Transcatheter Aortic Valve Implantation

Adhikari,

Bogati,

Timalsena

et al. 2024

J. Nat. Heart Lung Soc. Nep.

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Transcatheter aortic valve implantation (TAVI) has rapidly evolved in the last decade to become the treatment of choice for most patients with severe aortic stenosis. Acute coronary occlusion during TAVI is a rare and life-threatening complication with high morbidity and mortality rates. If coronary occlusion is considered highly likely to occur, a risk reassessment could favor surgical aortic valve replacement. An excessive surgical risk that mandates continuing with the transcatheter strategy requires coronary protection techniques. Coronary protection techniques include; Coronary wire protection, Chimney/snorkel stent technique, “Bioprosthetic Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction,” (BASILICA) technique, Splitting devices, and UNICORN procedure. In this case report we present our first experience of the “Chimney/Snorkel stent technique” for coronary protection in a case where coronary occlusion risk was high due to low coronary height, small sinus of Valsalva, and use of balloon-expandable valve.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Coronary Artery Protection with Chimney Stent in High-Risk Case of Coronary Occlusion in Transcatheter Aortic Valve Implantation

Adhikari,

Bogati,

Timalsena

et al. 2024

J. Nat. Heart Lung Soc. Nep.

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Successful management of acute left main coronary occlusion following transcatheter aortic valve implantation: a case report

Goranov,

Doktorova

2024

J Med Case Reports

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Background Transcatheter aortic valve implantation is an established, highly effective procedure in selected patients with severe degenerative aortic valve stenosis at high risk for conventional surgery. Case presentation We report a case of a 74-year-old Caucasian man who had an acute left main occlusion after transcatheter implantation of balloon-expandable valve prosthesis, followed by coronary intervention with successful recanalization. Conclusions Acute coronary occlusion is a rare life-threatening complication of transcatheter aortic valve implantation that is poorly predictable and requires immediate diagnosis and treatment.

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Coronary Artery Occlusion during Transcatheter Aortic Valve Implantation

et al. 2022

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Transcatheter aortic valve implantation (TAVI) is one of the rapidly evolving treatment strategies for severe aortic stenosis. Included in this category are inoperable, high, intermediate, and low surgical risk patients. It has varying types of complications that may require urgent surgical or transcatheter interventions to prevent procedural mortality and morbidity. Coronary artery occlusion is a rare and dreaded complication of TAVI. Here, we report a 73-year-old man who was diagnosed with severe aortic stenosis and underwent transfemoral TAVI. Unfortunately, during preimplantation balloon valvuloplasty, the patient developed severe hypotension along with ischemic changes on the electrocardiographic monitor. Promptly, coronary angiography was performed which revealed complete occlusion of the left anterior descending artery secondary to embolic debris. He was successfully rescued by manual aspiration thrombectomy (MAT). MAT results in restoration of coronary flow and reversal of shock condition before completing TAVI procedure.

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A Case of Acute Left Main Coronary Obstruction Following Transcatheter Aortic Valve Implantation

Cited by 3 publications

References 7 publications

Coronary Artery Protection with Chimney Stent in High-Risk Case of Coronary Occlusion in Transcatheter Aortic Valve Implantation

Coronary Artery Protection with Chimney Stent in High-Risk Case of Coronary Occlusion in Transcatheter Aortic Valve Implantation

Successful management of acute left main coronary occlusion following transcatheter aortic valve implantation: a case report

Coronary Artery Occlusion during Transcatheter Aortic Valve Implantation

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