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Challenges in coronary CTO intervention after TAVR: a case report and discussion
Shishir Murarka1, Ashish Pershad2
1Cardiology Fellow, Banner University Medical Center, Phoenix, AZ, USA.
Insights
Revascularization of chronic total occlusions (CTOs) after transcatheter aortic valve replacement (TAVR) is challenging due to prosthetic valve interference. This case demonstrates the first successful coronary CTO intervention post-TAVR, highlighting procedural complexities.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
- Prosthetic Heart Valves
Background:
- Coronary artery disease progression after transcatheter aortic valve replacement (TAVR) requires management.
- Revascularization can be hindered by the TAVR prosthesis, complicating access to coronary ostia.
- Chronic total occlusions (CTOs) represent the most complex coronary lesions, posing significant interventional challenges.
Abstract:
Progression of coronary arteries after transcatheter aortic valve replacement is an important issue. Coronary revascularization in these patients can be challenging because of potential hindrance posed by the artificial valve structure in getting access to the coronary ostium. This gets even more difficult in chronic total occlusions (CTOs) that represent the most complex subset of coronary lesions. We report the first case of coronary CTO revascularization in a patient who underwent TAVR a few months prior and discuss the complexities involved in intervening such lesions.
