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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation
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Improved Registration of 3D CT Angiography with X-ray Fluoroscopy for Image Fusion During Transcatheter Aortic Valve Implantation

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Recurrent angina from chronic coronary obstruction following transcatheter aortic valve implantation

Mohamad Kabach1, Abdulah Alrifai1, Stefanie Furlan1

  • 1Department of Internal Medicine, University of Miami Miller Palm Beach Regional Campus, Atlantis, Florida, USA.

Avicenna Journal of Medicine
|July 9, 2016
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) can complicate future coronary angiography and intervention. Proper TAVI prosthesis positioning is crucial to prevent coronary ostial obstruction, a rare but serious complication.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Severe aortic stenosis frequently coexists with coronary artery disease, necessitating interventions like coronary angiography (CA) and percutaneous coronary intervention (PCI).
  • Transcatheter aortic valve implantation (TAVI) is a common treatment for severe aortic stenosis, but it can present challenges for subsequent cardiac procedures.

Observation:

  • The feasibility of CA and PCI after TAVI is significantly influenced by the type and position of the implanted TAVI prosthesis.
  • Interference between diagnostic catheters and TAVI valve components can render procedures challenging or impossible.

Findings:

  • Correct positioning of the TAVI prosthesis during the initial implantation is a critical factor for enabling subsequent CA and PCI.
  • Coronary ostial obstruction is a rare but life-threatening complication associated with TAVI, particularly when coronary ostial height is not adequately assessed (minimum 10 mm).

Implications:

  • Meticulous attention to TAVI prosthesis placement is essential to ensure patient safety and maintain access for diagnosing and treating coronary artery disease.
  • Failure to ensure adequate coronary ostial height during TAVI can lead to coronary ostial obstruction, resulting in angina and impaired cardiac function.

Keywords:
Anginaaortic valvecoronary obstruction

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