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

Tahir Durmaz1, Huseyin Ayhan1, Telat Keles1

  • 1Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.

Texas Heart Institute Journal
|August 15, 2014
PubMed

Insights

Transcatheter aortic valve replacement can cause immediate coronary artery obstruction. Prompt recognition and intervention are vital for patients undergoing this procedure for severe aortic stenosis.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis in high-risk patients.
  • While generally safe, TAVR carries risks of complications, including coronary artery obstruction.

Observation:

  • A 78-year-old woman developed left main coronary artery obstruction due to calculus two hours post-TAVR.
  • The obstruction occurred after transfemoral implantation of an Edwards Sapien XT aortic valve.

Findings:

  • Despite prompt percutaneous coronary intervention, the patient experienced a fatal outcome.
  • This case highlights the potential for acute coronary obstruction following TAVR.

Implications:

  • Early detection of coronary artery obstruction post-TAVR is critical.
  • Timely and effective intervention strategies are essential to improve patient outcomes after TAVR.

Keywords:
Aortic valve stenosis/therapycalcinosis/complicationscoronary occlusion/etiologyfatal outcomeheart valve prosthesis implantation/adverse effects/methods/mortalityrisk assessment

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