Abstract

Background

Coronary artery obstruction after percutaneous aortic replacement is a complication with high short-term mortality secondary to the lack of timely treatment. There are various predictors of coronary obstruction prior to valve placement such as the distance from the ostia, the degree of calcification, the distance from the sinuses; In such a situation some measures must be taken to prevent and treat coronary obstruction.

Case presentation

An 84-year-old male, with severe aortic stenosis and high surgical risk, who was treated with TAVR. However, during the deployment of the valve he presented hemodynamic instability secondary to LMCA obstruction. The intravascular image showed obstruction of the ostium secondary to the displacement of calcium that he was successfully treated with a chimney stent technique.

Conclusions

The high degree of calcification and the left ostium near the annulus are conditions for obstruction of the ostium at the time of valve release; In this context, provisional stenting prior to TAVR in patients at high risk of obstruction should be considered as a safe prevention strategy to achieve the success of the procedure.

Details

Title
High risk of coronary artery obstruction during TAVR, how to avoid it?
Author
Gayosso-Ortíz, Jose R; Garcia-Garcia, Juan F; Merino-Rajme, Jose Alfredo; Muratalla-González, Roberto; Fuentes-Moreno, Juan C; Jiménez-Valverde, Arnoldo S; Alcantara-Melendez, Marco A; Aquino-Bruno, Heberto
Pages
1-5
Section
Case Report
Publication year
2024
Publication date
2024
Publisher
BioMed Central
e-ISSN
1749-8090
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3037873983
Copyright
© 2024. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.