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Coronary Injury in Mitral and Aortic Valve Surgery: A Case Series Using Optical Coherence Tomography

Roberto Scarsini1, Giovanni Luigi De Maria1, Jonathan Ciofani1

  • 1Oxford Heart Center, Oxford University Hospitals, NHS Trust, Oxford, United, Kingdom.

The Annals of Thoracic Surgery
|July 30, 2019
PubMed

Insights

Coronary occlusion after heart valve surgery is rare but serious. Intracoronary optical coherence tomography helps identify causes of coronary flow impairment during these procedures.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Coronary occlusion is a rare complication following heart valve surgery.
  • The left circumflex coronary artery is particularly vulnerable due to its proximity to the mitral valve annulus.
  • Dominant left circumflex arteries increase this risk.

Observation:

  • Three cases of acute coronary complications during valvular surgical procedures were observed.
  • These complications were diagnosed and managed in the cardiac catheterization laboratory.
  • Intracoronary optical coherence tomography (OCT) was employed for diagnosis.

Findings:

  • OCT identified the specific causes of coronary flow impairment.
  • The study provided insights into the mechanisms of intraoperative vascular damage.
  • This imaging technique proved crucial in understanding the pathophysiology.

Implications:

  • Early diagnosis and treatment in the catheterization lab can mitigate adverse outcomes.
  • Understanding intraoperative vascular damage mechanisms can improve surgical techniques.
  • Intracoronary OCT is a valuable tool for managing coronary complications in valvular surgery.

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