Coral Reef Aorta - A rare occlusive disease of the aorta complicating decision making for severe aortic stenosis treatment

Publication date: Available online 29 April 2019Source: Canadian Journal of CardiologyAuthor(s): Ottavia Cozzi, Damiano Regazzoli, Enrico Citterio, Alexia Rossi, Mauro Chiarito, Giulio G. Stefanini, Renato Bragato, Lucia Torracca, Gianluigi Condorelli, Paolo Pagnotta, Bernhard ReimersAbstractThe incidental finding of a severe occlusive disease of the aorta (“coral reef aorta”) during the assessment for TAVR of a 75-year-old woman with severe aortic stenosis, complicated the Heart Team process and lead to consider different access route in order to find the safest and most appropriate strategy of intervention. A successful transapical TAVR was eventually performed. Coral reef aorta, though rare, is associated with great morbidity and mortality, and it needs to be recognized when planning intravascular procedures, both for a safer selection of treatment approach, and for the prevention of intraprocedural and postprocedural morbidity.A 75-year-old woman was admitted to our department due to worsening effort dyspnea. Her past medical history comprised mild chronic obstructive pulmonary disease, hypertension and dyslipidaemia.Transthoracic echocardiography showed severe aortic valve stenosis (mean gradient 40 mmHg, peak velocity 4,2 m/s) and associated mild regurgitation; left ventricle contractility was normal as were mitral and tricuspid valves.Subsequent diagnostic evaluation included carotid duplex ultrasound, that showed moderate bilateral internal carotid arteries stenos...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research