Cor Vasa 2008, 50(1):39-42 | DOI: 10.33678/cor.2008.016

Successful catheter-based management of iatrogenic left main coronary artery stenosis following aortic valve replacement

Hana Pecková, Josef Kautzner, Eva Koudelková, Tomáš Marek, Michael Želízko

Klinika kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

The paper is the case report of a 74-year female patient with critical ostial left main coronary artery stenosis as a complication of a repeat procedure on the aortic valve. The likely cause seemed to be antegrade blood cardioplegia, scarring due to injury to the coronary arteries and aortic root, or a combination of both. Four months after, the complication manifested by unstable angina and was successfully managed by percutaneous transluminal coronary angioplasty combined with metalic stent implantation. Iatrogenic stenosis of the left main coronary artery is a very rare, yet potentially fatal, complication of aortic valve replacement. The dominant clinical feature is rapidly evolving angina, with ischemia-triggered ventricular arrhythmias, lung edema, or sudden death occurring less often. The diagnosis is to be considered in all patients with similar manifestations following aortic valve replacement.

Keywords: Iatrogenic coronary artery stenosis; Left main coronary artery; Aortic valve replacement; Percutaneous transluminal coronary angioplasty

Published: January 1, 2008  Show citation