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Delayed coronary artery occlusion after transcatheter aortic valve replacement and chimney stenting: a case report

Hui Li1,2, Wenduo Zhang2, Bo Xia2

  • 1Fifth School of Clinical Medicine, Peking University, Beijing, People's Republic of China.

BMC Cardiovascular Disorders
|September 18, 2021
PubMed

Insights

Delayed coronary artery occlusion (CAO) after transcatheter aortic valve replacement is a rare but serious complication. A novel case involved a deformed chimney stent causing CAO, requiring reintervention.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Delayed coronary artery occlusion (CAO) is a rare but potentially fatal complication post-TAVR.
  • Chimney stenting is the established technique for managing CAO or impending CAO.

Observation:

  • A patient developed non-ST elevation myocardial infarction 4 months after TAVR and chimney stenting.
  • Angiography revealed delayed CAO due to a previously unreported deformed stent.
  • The patient underwent successful treatment with a new chimney stent.

Findings:

  • Delayed CAO can occur even with chimney stenting used to protect the coronary ostium in self-expanding TAVR valves.
  • Stent deformation is a potential, uncharacterized cause of delayed CAO post-chimney stenting.
  • Successful reintervention with a new chimney stent is feasible.

Implications:

  • This case highlights the importance of considering stent integrity in delayed CAO after TAVR with chimney stenting.
  • Further investigation into stent behavior and potential deformation is warranted.
  • This underscores the need for vigilance and tailored management strategies for rare TAVR complications.
Abstract

Keywords:
Chimney stentingCoronary artery occlusionTranscatheter aortic valve replacement

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