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Cardiac computed tomography in the management of iatrogenic coronary ostial stenosis after aortic valve replacement
Payam Dehghani1, Tom Elliott, Lanna Olson
1Department of Cardiology, Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada. payamde@gmail.com
Insights
Iatrogenic coronary ostial stenosis, a rare complication of aortic valve replacement and Bentall procedure, can cause acute coronary syndrome. Cardiac computed tomography aids in diagnosing and managing these occlusions.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Iatrogenic coronary ostial stenosis is a rare but significant complication following aortic valve replacement and Bentall procedures.
- These stenotic lesions commonly affect the left main coronary artery or venous bypass graft anastomoses with aortic grafts.
Abstract:
Although rare, iatrogenic coronary ostial stenosis is an important complication of aortic valve replacement and Bentall procedure. We report a 32-year-old male presenting an acute coronary syndrome post-Bentall procedure and the role of computed tomography in diagnosis and management of iatrogenic coronary ostial stenosis. Such occlusions are commonly identified in the left main coronary artery, but can develop in venous bypass grafts at anastomoses with Dacron aortic grafts. Cardiac computed tomography is valuable to exclude noncoronary causes of chest pain, assess ostial stenosis of manipulated arteries post reimplantation, and shed light on mechanisms and management of these lesions.
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