Sudden death after valve-in-valve procedure due to delayed coronary obstruction: a case report.

Autor: Buscaglia A; Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Largo Rosanna Benzi, 10 1632, Genoa, Italy. buscaglia_angelo@hotmail.it., Tini G; Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Largo Rosanna Benzi, 10 1632, Genoa, Italy., Bezante GP; Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Largo Rosanna Benzi, 10 1632, Genoa, Italy., Brunelli C; Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Largo Rosanna Benzi, 10 1632, Genoa, Italy., Balbi M; Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Largo Rosanna Benzi, 10 1632, Genoa, Italy.
Jazyk: angličtina
Zdroj: Journal of medical case reports [J Med Case Rep] 2018 Sep 05; Vol. 12 (1), pp. 247. Date of Electronic Publication: 2018 Sep 05.
DOI: 10.1186/s13256-018-1785-x
Abstrakt: Background: Valve-in-valve transcatheter aortic valve implantation for degenerated aortic bioprostheses is an effective option for patients at high risk for redo surgery, even if it may be burdened by complications more common in specific settings, such as, coronary artery obstruction.
Case Presentation: We present the case of a Caucasic 84-year-old woman with degeneration of a previously implanted aortic Mitroflow bioprosthesis. She underwent a valve-in-valve transcatheter aortic valve implantation with a CoreValve® bioprosthesis. End-procedure coronary angiography demonstrated maintained perfusion of both coronary arteries. However, few hours later, she experienced sudden cardiac death. An autopsy showed that Mitroflow prosthesis leaflets were higher than the left main coronary ostium, and no other possible cause for the sudden death. Fatality was thus ascribed to left main coronary ostium obstruction due to apposition of the Mitroflow leaflet pushed upward by the late expansion of CoreValve®.
Conclusions: Coronary artery obstruction is a frequently fatal complication which usually presents just after valve implantation, but, as reported in our case, it may also have a delayed presentation. Accurate patient's selection and intraoperative preventive measures can reduce this eventuality.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje