scholarly journals Mobilization of an anomalous retro aortic coronary artery to prevent myocardial ischemia after aortic valve replacement

2021 ◽  
Author(s):  
José Máximo ◽  
Paulo Pinho ◽  
Jorge Casanova
Keyword(s):  
At Risk ◽  
Case Report ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Myocardial Ischemia ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Valvular Surgery

During valvular surgery, abnormal coronary distribution, especially if unidentified by preoperative exams, may put coronary arteries at risk of damage. In this case report, we describe the approach to an anomalous right coronary artery during aortic valve replacement.

scholarly journals Low Origin of the Coronary Arteries and a Small Aortic Annulus Complicating Aortic Valve Replacement

2019 ◽  
Vol 46 (3) ◽  
pp. 222-224 ◽  
Author(s):  
Milinda Withana ◽  
Carlo Uribe ◽  
Igor D. Gregoric ◽  
Paolo Angelini
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Perioperative Period ◽  
Aortic Annulus ◽  
Inferior Wall ◽  
Surgical Aortic Valve Replacement

Low origin of the coronary arteries, defined as an origin less than 10 mm above the functional aortic annulus, is not usually considered to be a notable anomaly because functional impairment is not intrinsic. We describe a case of severe complications after surgical aortic valve replacement in a 59-year-old woman who had symptomatic aortic valve stenosis, low origin of both main coronary arteries, and a hypoplastic aortic annulus less than 19 mm in diameter. The aortic prosthesis had to be implanted above the hypoplastic anatomic annulus. An inferior-wall myocardial infarction, hypotension, right-sided heart failure, and atrial fibrillation developed during the early perioperative period. Coronary angiograms showed occlusion of the right coronary artery ostium and critical stenosis of the left coronary ostium. During reoperation, posterior aortic patch annuloplasty enabled lower reimplantation of the prosthetic aortic valve, jointly with right coronary artery–venous grafting. To prevent potentially severe complications, we recommend that low origin of the coronary arteries be reported before patients undergo surgical aortic valve replacement. If the ostia are not seen when routine coronary angiography is used, computed tomography should be prospectively performed to characterize this anomaly.

scholarly journals Obstruction of 2 Coronary Arteries from Different Causes Immediately after Transapical Transcatheter Aortic Valve Replacement

2020 ◽  
Vol 47 (1) ◽  
pp. 30-34
Author(s):  
Umihiko Kaneko ◽  
Ryuji Koshima ◽  
Hirosato Doi ◽  
Tsutomu Fujita
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Coronary Arteries ◽  
Transcatheter Aortic Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Rare Complication ◽  
Left Main ◽  
Transcatheter Aortic Valve

Coronary obstruction, a rare complication of transcatheter aortic valve replacement, can be fatal. Few data exist on this phenomenon, and, to date, authors have reported only single coronary lesions. We present a case in which 2 coronary arteries obstructed immediately after transapical transcatheter aortic valve replacement. The patient was an 81-year-old woman with symptomatic severe aortic stenosis who underwent transapical transcatheter aortic valve replacement. Immediately after an Edwards Sapien XT valve was deployed, she experienced sudden cardiogenic shock resulting from obstruction of the left main coronary artery ostium and the distal left anterior descending coronary artery. The left main obstruction was caused by direct compression from a large calcified mass and the valve frame. The left anterior descending coronary artery obstruction was caused by ambient myocardial tightening and external compression around the apical sutures. Revascularization was achieved through coronary stent placement and suture removal, respectively. Our patient's case highlights the risk for coronary obstructions after transapical transcatheter aortic valve replacement, and we discuss how they can be managed.

scholarly journals Case Report: Post transcatheter aortic valve replacement shock: Value of multimodal imaging

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2032 ◽  
Author(s):  
Sujatha P. Bhandary ◽  
Andrew J. Otey ◽  
Thomas J. Papadimos ◽  
Juan A. Crestanello ◽  
Barry S. George ◽  
...  
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Multimodal Imaging ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Transcatheter Aortic Valve

Complications resulting from the delayed clinical presentation of a left main coronary artery obstruction can be catastrophic. This case report presents a 73-year-old woman with severe aortic stenosis who underwent transcatheter aortic valve replacement with a core valve who, approximately 20 minutes after heparin reversal with protamine, became hypotensive and was unresponsive to vasopressor and inotropic therapy. Transesophageal echocardiography demonstrated global hypokinesis, which was highly consistent with the occlusion of the left main coronary artery. Angiography confirmed this diagnosis and demonstrated that valve positioning had not changed compared to post-placement examination. Here we report the partial covering of the ostium of the left main coronary artery by a core valve skirt that converted into a total occlusion following the initiation of heparin reversal with protamine and the value of multimodal imaging in the management of this case.

Chylopericardium following aortic valve replacement and coronary artery bypass surgery: a case report and discussion

1994 ◽  
Vol 3 (4) ◽  
pp. 313-315
Author(s):  
M Schactman ◽  
C Scott ◽  
DR Glibbery-Fiesel ◽  
M Murello ◽  
P Kerr
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass

The incidence of chylopericardium after cardiac surgery is unusual, but there are documented cases. Those caring for these patients need to be aware of the symptoms and management of chylopericardium because, if left untreated, it may cause catastrophic consequences.

scholarly journals Left main coronary artery bifurcation angioplasty and stenting after aortic valve replacement: a case report

2012 ◽  
Vol 64 (1) ◽  
pp. 80-83
Author(s):  
Sanjeeb Roy ◽  
Ajeet Bana ◽  
Rajeev Gupta ◽  
Rakesh Chittora ◽  
Sameer Sharma ◽  
...  
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Main Coronary Artery ◽  
Left Main ◽  
Angioplasty And Stenting
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