Suspected coronary ostium calcification identified as a protruding stent by epiaortic echography

Abstract

A 76-year-old male patient was admitted for mitral valvuloplasty. He had suffered a myocardial infarction 7 months earlier, and two stents had been inserted in the left main coronary artery and left circumflex artery. Intraoperative transesophageal echocardiography revealed a 10 × 8 mm echogenic mass at the ostium of the left main coronary artery. We initially suspected severe atheromatous calcification at the coronary ostium, which might require aortotomy and removal, but we decided to perform an epiaortic ultrasonographic scan first to obtain better images and reevaluate. Epiaortic scanning with a linear sonographic probe identified the mass as a protruding coronary stent.

Left Main Coronary Artery Stent Misadventure

“…The most frequent complications are in-stent restenosis, stent fracture, thrombosis, and malposition, which can increase the risk of early and late coronary events and/or damage to the aortic valve. A malpositioned LMCA stent may be treated surgically ( 1 ) or conservatively ( 2 ). These 2 patients underwent surgery.…”