Percutaneous Coronary Intervention: A Rare Cause of Acute Traumatic Aortic Regurgitation

Chulián, Sergio Gamaza; Freire, Santiago Jesús Camacho; Jiménez, Javier León; Luna, Antonio Agarrado; Martínez, Tomás Daroca

doi:10.1016/j.rec.2016.09.017

Cited by 3 publications

(6 citation statements)

References 4 publications

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“…The aortic leaflet perforations remain a rare but serious complication associated with percutaneous coronary intervention. [ 1 2 3 4 5 6 7 8 7 ] The central position of the valve makes it more likely to iatrogenic injuries during percutaneous interventions. [ 6 ] These injuries are caused by the multiple passages of stiff guidewires[ 1 5 6 ] or, protrusion of a right coronary artery ostium stent onto the valve.…”

Section: Discussionmentioning

confidence: 99%

“…[ 1 2 3 4 5 6 7 8 7 ] The central position of the valve makes it more likely to iatrogenic injuries during percutaneous interventions. [ 6 ] These injuries are caused by the multiple passages of stiff guidewires[ 1 5 6 ] or, protrusion of a right coronary artery ostium stent onto the valve. [ 2 3 4 7 ] Transient aortic regurgitations have also been reported due to excessive movement of a rigid catheter in the aorta.…”

Section: Discussionmentioning

confidence: 99%

“…Aortic valve injury is a rare complication during percutaneous coronary intervention, with reported incidence of 0.008%-0.20%. [ 1 ] A handful of cases have been reported in the past, mostly causing acute decompensation due to injury to the aortic valve leaflets;[ 1 2 3 4 5 6 7 ] however, rarely such injury may get unnoticed in the acute phase and present as chronic aortic regurgitation. We describe a 51-year-old man with history of coronary artery stenting 2 years back was scheduled for coronary artery bypass grafting and aortic valve replacement for coronary artery disease and moderate aortic regurgitation.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic aortic regurgitation following percutaneous coronary intervention

Singh

Kumar²,

Ghotra³

et al. 2021

Annals of Cardiac Anaesthesia

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The incidence aortic valve injury during percutaneous coronary intervention is scarce, mostly resulting in acute aortic regurgitation. However, rarely patients may remain asymptomatic in the immediate post-procedure period and present latter with chronic aortic regurgitation. Determining etiology of such an aortic regurgitation may be challenging. We present a case of a 51-year-old man with history of percutaneous coronary intervention for coronary artery disease and moderate aortic regurgitation scheduled for coronary artery bypass grafting and aortic valve replacement. Intra-operative transesophageal echocardiography was instrumental in deciding etiology of aortic regurgitation that change surgical management of the patient.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Iatrogenic aortic regurgitation following percutaneous coronary intervention

Singh

Kumar²,

Ghotra³

et al. 2021

Annals of Cardiac Anaesthesia

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“…Due to the low incidence of coronary events in IE, only case reports and small studies have been published 6–9 ; thus, the current literature on the management of these patients does not give clear recommendations. Bacteraemia impairs haemostasis; consequently, the value of anticoagulation in the prevention of embolism is limited in IE patients and can raise the risk of bleeding 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Because the ischaemia is more likely to be secondary to paravalvular complications, 1 , 15 in this case, the patient should be referred for valvular surgery without having a coronary angiography. Conversely, if there is ST-segment elevation, diagnostic coronary angiography is performed; if a coronary occlusion is demonstrated, thromboaspiration is recommended as the initial strategy, and if successful, the only strategy for these patients 6 , 16 …”

Section: Discussionmentioning

confidence: 99%

Myocardial infarction associated with infective endocarditis: a case series

Calero-Núñez

Bleda

Corbí-Pascual

et al. 2018

European Heart Journal - Case Reports

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Introduction Embolic myocardial infarction is an uncommon but increasingly recognized complication of infective endocarditis (IE). Its incidence ranges between 1% and 10%, but it has a high mortality rate. A high index of suspicion is required to diagnose it. Only case reports and small studies on this condition have been published; thus, it is unknown what the ideal treatment is. We review the challenges to diagnosing this disease and the most effective treatments for it. Case presentation We report a case series of three patients with acute coronary syndrome (ACS) in IE. The first patient presented with non-ST-elevation ACS. He underwent a stent placement for late-diagnosed embolic myocardial infarction, after which he was treated conservatively without valve replacement, with good results. The second patient with ST-elevation presented with ACS, for which conventional balloon angioplasty and successful double valve replacement were performed. ST-elevation ACS was also observed in the last patient, who experienced periannular complications, which necessitated surgery. Discussion Acute coronary syndrome is a rare complication of IE but is associated with an increased risk of heart failure and high mortality rate. Its management is complicated and cannot be standardized. Because each situation is unique, a multidisciplinary discussion is required to choose the best treatment.

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Severe chronic aortic regurgitation after percutaneous coronary intervention: a case report and literature review

Wedin

Vikholm

Alström

et al. 2021

European Heart Journal - Case Reports

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Background Severe aortic regurgitation (AR) is an extremely rare complication after coronary catheterization and percutaneous coronary intervention (PCI), where most reported cases have required relatively urgent surgical intervention due to acute-onset AR and cardiac decompensation. Case summary We report a case of a 60-year-old woman that previously presented with a non-ST-elevation myocardial infarction (NSTEMI) due to an ostial right coronary artery stenosis. During the course of 2 years, she developed five recurrent NSTEMI due to in-stent thrombosis, necessitating either a new coronary stent or balloon. She developed a chronic severe AR due to a drug-eluting coronary stent protruding from the right coronary artery and underwent successful aortic valve replacement and coronary artery by-pass grafting. Discussion We performed a literature review and identified 16 reported cases of iatrogenic severe aortic regurgitation related to coronary catheterization or percutaneous coronary intervention. All patients developed an acute aortic regurgitation and, thus, we report the first case of a delayed complication caused by a protruding coronary stent. The surgical strategy is related to the extent of the damage, where smaller perforations or lacerations seems to be feasible for aortic valve repair and larger defects more often lead to aortic valve replacement. Our patient developed a fibrotic right coronary cusp which could not be used to perform a successful aortic valve repair.

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Percutaneous Coronary Intervention: A Rare Cause of Acute Traumatic Aortic Regurgitation

Cited by 3 publications

References 4 publications

Iatrogenic aortic regurgitation following percutaneous coronary intervention

Iatrogenic aortic regurgitation following percutaneous coronary intervention

Myocardial infarction associated with infective endocarditis: a case series

Severe chronic aortic regurgitation after percutaneous coronary intervention: a case report and literature review

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