Delayed coronary obstruction of the left main artery after transcatheter aortic valve replacement

Coronary arteries obstruction associated with transcatheter aortic valve implantation (TAVI) may occur either during the procedure or after it. In the latter coronary obstruction can be further divided into early (7 days after procedure) or delayed one (7 days). Delayed coronary obstruction (DCO) is referred as a rare but devastating complication after TAVI and is associated with the extremely high mortality. This case demonstrates the objective difficulties of timely diagnostics of DCO. Since the results of non-invasive methods are indetermined in most cases, the authors conclude that even low-specific clinical symptoms must be interpreted as the definite rationale for the implementation of invasive diagnostic and treatment strategy.

Download Full-text

Delayed-Onset Left Main Coronary Artery Obstruction More than 24 Hours after Balloon-Expandable Transcatheter Aortic Valve Replacement

Texas Heart Institute Journal ◽

10.14503/thij-15-5475 ◽

2016 ◽

Vol 43 (5) ◽

pp. 441-445 ◽

Cited By ~ 1

Author(s):

Tsuyoshi Isawa ◽

Norio Tada ◽

Tatsushi Ootomo

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Left Main Coronary Artery ◽

Left Ventricular ◽

Left Main ◽

Transcatheter Aortic Valve ◽

Valve Implantation ◽

Coronary Obstruction

Coronary obstruction during or after transcatheter aortic valve replacement is a rare and catastrophic sequela that occurs most frequently just after valve implantation. Even rarer is the delayed clinical presentation, in some few patients, of coronary obstruction on the day after self-expandable valve implantation. Here we describe a case of balloon-expandable (not self-expandable) transcatheter aortic valve replacement, followed by partial obstruction of the left main coronary artery on the day after that procedure in a 93-year-old man, despite normal left ventricular contraction just after valve implantation. Visual evaluation of the echocardiogram for left ventricular wall motion was not sufficient, by itself, to achieve early diagnosis of the obstruction. We performed emergency percutaneous coronary intervention. Ninety days after the procedure, the patient was in New York Heart Association functional class I.

Download Full-text

Coronary obstruction after valve-in-valve transcatheter aortic valve implantation: salvage with stent in the left main stem

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezw305 ◽

2016 ◽

pp. ezw305

Author(s):

Lars Oliver Conzelmann ◽

Uwe Mehlhorn ◽

Claus Schmitt ◽

Gerhard Schymik

Keyword(s):

Aortic Valve ◽

Transcatheter Aortic Valve Implantation ◽

Main Stem ◽

Left Main ◽

Transcatheter Aortic Valve ◽

Left Main Stem ◽

Valve In Valve ◽

Aortic Valve Implantation ◽

Valve Implantation ◽

Coronary Obstruction

Download Full-text

Computed Tomography Imaging in the Context of Transcatheter Aortic Valve Implantation (TAVI)/Transcatheter Aortic Valve Replacement (TAVR)

JACC Cardiovascular Imaging ◽

10.1016/j.jcmg.2018.12.003 ◽

2019 ◽

Vol 12 (1) ◽

pp. 1-24 ◽

Cited By ~ 55

Author(s):

Philipp Blanke ◽

Jonathan R. Weir-McCall ◽

Stephan Achenbach ◽

Victoria Delgado ◽

Jörg Hausleiter ◽

...

Keyword(s):

Computed Tomography ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Computed Tomography Imaging ◽

Tomography Imaging ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

Download Full-text

Calcium Resection to Relieve Left Main Coronary Obstruction in Transcatheter Aortic Valve Replacement

Journal of Cardiac Surgery ◽

10.1111/jocs.12752 ◽

2016 ◽

Vol 31 (5) ◽

pp. 315-317 ◽

Cited By ~ 2

Author(s):

Gilbert H. L. Tang ◽

Hasan Ahmad ◽

Martin Cohen ◽

Cenap Undemir ◽

Steven L. Lansman

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Left Main ◽

Transcatheter Aortic Valve ◽

Coronary Obstruction

Download Full-text

The TAVI: Transcatheter Aortic Valve Implantation

CARDIOLOGIA AMBULATORIALE ◽

10.17473/1971-6818-2020-1-4 ◽

2020 ◽

pp. 49-57

Author(s):

Giovanni Esposito ◽

Anna Franzone

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Implantation ◽

Transcatheter Aortic Valve Replacement ◽

Transcatheter Aortic Valve ◽

Aortic Valve Implantation ◽

Valve Implantation

L’impianto transcatetere di valvola aortica (Transcatheter Aortic Valve Replacement, TAVI) è una procedura di cardiologia interventistica, introdotta nel 2002, che prevede il posizionamento e l’impianto di una protesi biologica a livello dell’annulus aortico mediante accesso percutaneo, prevalentemente transfemorale. Dopo le prime esperienze cliniche, riservate a pazienti senza altre opzioni terapeutiche, la TAVI si è affermata come alternativa all’intervento chirurgico tradizionale di sostituzione valvolare grazie ad una serie di studi randomizzati che ne hanno dimostrato l’efficacia e la sicurezza in pazienti appartenenti a tutto lo spettro del rischio operatorio (da estremo a basso). L’utilizzo della TAVI è in continua crescita, a livello mondiale, e si assiste ad una progressiva espansione delle sue indicazioni cliniche (stenosi di valvola bicuspide, insufficienza aortica severa). Il presente articolo ha lo scopo di riassumere i recenti progressi nell’ambito del trattamento transcatetere della stenosi valvolare aortica, descrivere le caratteristiche della procedura e analizzare i risultati degli studi che ne hanno favorito la diffusione nella pratica clinica.

Download Full-text