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Acute coronary occlusion by injured aortic valve during percutaneous coronary intervention

Osamu Akutagawa1, Yoshiyuki Kijima, Yusuke Nakagawa

  • 1Department of Cardiology, Higashi-Osaka City General Hospital, 3-4-5 Nishi Iwata, Higashi-Osaka, Osaka, 578-8588, Japan.

Cardiovascular Intervention and Therapeutics
|October 15, 2013
PubMed

Insights

A rare case of left main trunk (LMT) artery occlusion during percutaneous coronary intervention (PCI) occurred due to an injured aortic valve. This complication was managed with LMT stenting, but resulted in aortic regurgitation.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
  • Complications, though rare, can occur during PCI, necessitating prompt management.
  • Aortic valve injury during PCI is an infrequent but serious event.

Observation:

  • A 58-year-old male experienced accidental left main trunk (LMT) artery occlusion during PCI.
  • The occlusion was caused by an injured aortic valve.
  • Aortic regurgitation developed immediately after PCI, with echocardiography showing a filamentous structure on the valve.

Findings:

  • Urgent LMT stenting successfully managed the occlusion.
  • Aortic valve replacement surgery revealed a torn right coronary cusp.
  • One torn cusp strip occluded the LMT and was secured by the stent; the other mimicked infective endocarditis vegetation.

Implications:

  • Meticulous guiding catheter manipulation is crucial during PCI to prevent aortic valve injury.
  • This case highlights a rare mechanism of LMT occlusion and aortic regurgitation post-PCI.
  • Awareness of such potential complications can improve patient safety during interventional procedures.

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