A case of acute coronary syndrome caused by delayed coronary ischemia after transcatheter aortic valve implantation

Publication date: Available online 8 December 2017 Source:Journal of Cardiology Cases Author(s): Yuichi Ninomiya, Shuichi Hamasaki, Yutaro Nomoto, Takeko Kawabata, Daichi Fukumoto, Akino Yoshimura, Shunichi Imamura, Masakazu Ogawa, Yuta Shiramomo, Keisuke Kawaida, Goichi Yotsumoto, Hiroto Suzuyama, Kazuhiro Nishigami, Tomohiro Sakamoto, Mitsuru Ohishi An 84-year-old female patient suffered from dyspnea due to severe aortic stenosis. Several comorbidities and her advanced age made her acceptable for transcatheter aortic valve implantation (TAVI). The TAVI procedure was performed via a femoral access and a 26-mm CoreValve prosthesis (Medtronic, Minneapolis, MN, USA) was implanted. The prosthesis was deployed at a high position because of short distance between the annulus base and coronary arteries. Aortic angiography indicated normal contrast flow into both coronary arteries. Six months later she was readmitted to our hospital because of acute coronary syndrome. Although selective intubation of coronary arteries could not be achieved because of high valve position, both coronary arteries seemed to be well contrasted. As a consequence, the second coronary angiography was undertaken because of recurring chest pains. The aortic root angiogram showed a decreased contrast flow into both coronary arteries. During the examination she deteriorated rapidly, developed cardiopulmonary arrest, and a percutaneous cardiopulmonary support and an intra-aortic balloon pump nee...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research