A case of acute coronary syndrome caused by delayed coronary ischemia after transcatheter aortic valve implantation

An 84-year-old female patient suffered from dyspnea due to severe aortic stenosis. Several comorbidities and her advanced age made her acceptable for transcatheter aortic valve implantation (TAVI). The TAVI procedure was performed via a femoral access and a 26-mm CoreValve prosthesis (Medtronic, Min...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cardiology cases 2018-04, Vol.17 (4), p.107-110
Main Authors: Ninomiya, Yuichi, Hamasaki, Shuichi, Nomoto, Yutaro, Kawabata, Takeko, Fukumoto, Daichi, Yoshimura, Akino, Imamura, Shunichi, Ogawa, Masakazu, Shiramomo, Yuta, Kawaida, Keisuke, Yotsumoto, Goichi, Suzuyama, Hiroto, Nishigami, Kazuhiro, Sakamoto, Tomohiro, Ohishi, Mitsuru
Format: Article
Language:English
Subjects:
Delayed coronary ischemia
Transcatheter aortic valve implantation
Valve replacement
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:An 84-year-old female patient suffered from dyspnea due to severe aortic stenosis. Several comorbidities and her advanced age made her acceptable for transcatheter aortic valve implantation (TAVI). The TAVI procedure was performed via a femoral access and a 26-mm CoreValve prosthesis (Medtronic, Minneapolis, MN, USA) was implanted. The prosthesis was deployed at a high position because of short distance between the annulus base and coronary arteries. Aortic angiography indicated normal contrast flow into both coronary arteries. Six months later she was readmitted to our hospital because of acute coronary syndrome. Although selective intubation of coronary arteries could not be achieved because of high valve position, both coronary arteries seemed to be well contrasted. As a consequence, the second coronary angiography was undertaken because of recurring chest pains. The aortic root angiogram showed a decreased contrast flow into both coronary arteries. During the examination she deteriorated rapidly, developed cardiopulmonary arrest, and a percutaneous cardiopulmonary support and an intra-aortic balloon pump needed to be inserted. She was then transferred to the operating room for aortic valve replacement. This is the first case of delayed coronary ischemia after TAVI, necessitating the removal of an implanted CoreValve and its replacement with a new prosthetic valve.
ISSN:1878-5409
1878-5409
DOI:10.1016/j.jccase.2017.11.003