Left main coronary artery obstruction by dislodged native-valve calculus after transcatheter aortic valve replacement

Tex Heart Inst J. 2014 Aug 1;41(4):414-7. doi: 10.14503/THIJ-13-3410. eCollection 2014 Aug.

Abstract

Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement.

Keywords: Aortic valve stenosis/therapy; calcinosis/complications; coronary occlusion/etiology; fatal outcome; heart valve prosthesis implantation/adverse effects/methods/mortality; risk assessment.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / therapy*
  • Aortic Valve*
  • Calculi / diagnosis
  • Calculi / etiology*
  • Calculi / therapy
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / instrumentation
  • Coronary Angiography
  • Coronary Occlusion / diagnosis
  • Coronary Occlusion / etiology*
  • Coronary Occlusion / therapy
  • Echocardiography, Transesophageal
  • Fatal Outcome
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis*
  • Humans
  • Percutaneous Coronary Intervention
  • Prosthesis Design
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Vascular Calcification / diagnosis
  • Vascular Calcification / etiology*
  • Vascular Calcification / therapy