Coronary thrombosis after Bentall's procedure in a patient with Ehlers-Danlos syndrome: a case report
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Updated: Jun 14, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Jixuan Zheng1, Qin Yin2, Yuqiang Wang1
1Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
Insights
Vascular Ehlers-Danlos syndrome (vEDS) patients undergoing cardiac surgery face a high risk of acute coronary syndrome (ACS). Early intervention with percutaneous coronary intervention (PCI) successfully treated a LAD ostial thrombus in a vEDS patient post-Bentall procedure.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Interventional Cardiology
Background:
- Acute coronary syndrome (ACS) is a rare but serious complication after cardiac valve replacement.
- Patients with vascular Ehlers-Danlos syndrome (vEDS) have a genetic predisposition increasing coronary thrombosis risk.
- Bentall surgery, coronary manipulation, and anticoagulation instability heighten thrombotic risk, especially with mechanical valves.
Background:
Acute coronary syndrome (ACS) following cardiac valve replacement is a rare but severe complication. Patients with vascular Ehlers-Danlos syndrome (vEDS) may exhibit an increased propensity for coronary thrombosis due to their genetic predisposition. After Bentall surgery, coronary manipulation and early postoperative anticoagulation instability may further contribute to thrombotic risk, particularly after mechanical valve implantation.
Case Presentation:
A 33-year-old male presenting with acute chest pain underwent a Bentall procedure for vEDS-complicated type A aortic dissection and received postoperative anticoagulation. Twenty days postoperatively, angiography and IVUS revealed a thrombus at the left anterior descending artery (LAD) ostium. Following a multidisciplinary discussion, percutaneous coronary intervention (PCI) was successfully performed to remove the thrombus and restore blood flow.
Conclusions:
We discuss the risk of ACS following cardiac surgery, especially in vEDS patients, as well as strategies for early identification, timely intervention, and optimization of perioperative anticoagulation management.
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