Coronary artery dissection following aortic valve replacement. How can one deal with this rare yet life‐threatening complication?

2019 ◽  
Vol 34 (3) ◽  
pp. 147-150
Author(s):  
Patrycja Molek ◽  
Jadwiga Nessler ◽  
Jaroslaw Zalewski
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Life Threatening ◽  
Life Threatening Complication

Chest Pain after Aortic Valve Replacement: Rupture of Right Sinus of Valsalva Presenting as Myocardial Infarction

Cardiology ◽  
2016 ◽  
Vol 134 (1) ◽  
pp. 22-25 ◽  
Author(s):  
Jianqing She ◽  
Zhan Hu ◽  
Yangyang Deng ◽  
Fuqiang Liu ◽  
Zuyi Yuan
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Right Coronary Artery ◽  
Artery Dissection ◽  
Sinus Of Valsalva ◽  
Coronary Artery Dissection ◽  
The Right

Background: A 47-year-old male presented with retrosternal chest pain, which had started 4 days previously and had become excruciating for the past 6 h. He had undergone mechanical aortic valve replacement surgery 4 months previously. Investigation: Electrocardiography, echocardiography, computed tomography-angiography of the aorta. Diagnosis: Rupture of the right sinus of Valsalva and right coronary artery dissection. Management: The defect in the right coronary sinus was closed, and the dissection at the root of the right coronary artery was resected and the right coronary artery bypassed to the root of the aorta.

Left Main Coronary Artery Dissection During Aortic Valve Replacement

2017 ◽  
Vol 124 (6) ◽  
pp. 1789-1791 ◽  
Author(s):  
Kenta Nakao ◽  
Toshiyuki Sawai ◽  
Junko Nakahira ◽  
Ayako Hamakawa ◽  
Hisanari Ishii ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Main Coronary Artery ◽  
Artery Dissection ◽  
Left Main ◽  
Coronary Artery Dissection

scholarly journals Recanalization After False Lumen Stent Placement During Iatrogenic Coronary Dissection: A Case Report.

2021 ◽  
Author(s):  
Jing Li ◽  
Liang Dong
Keyword(s):  
Case Report ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Stent Placement ◽  
False Lumen ◽  
Artery Dissection ◽  
Coronary Artery Dissection ◽  
Life Threatening ◽  
Life Threatening Complication

Abstract Iatrogenic coronary artery dissection is an uncommon but life-threatening complication of coronary angiography and angioplasty. It may result in devastating consequences if not promptly treated with immediate revascularization. We report a case of recanalization after false lumen stent placement during iatrogenic coronary dissection.

Early and Late Mortality of Patients Undergoing Aortic Valve Replacement After Previous Coronary Artery Bypass Graft Surgery

Circulation ◽  
1995 ◽  
Vol 92 (9) ◽  
pp. 163-168 ◽  
Author(s):  
Sayid F. Fighali ◽  
Amilcar Avendaño ◽  
MacArthur A. Elayda ◽  
Vei Vei Lee ◽  
Cesar Hernandez ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Valve Replacement ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Late Mortality

scholarly journals Surgical Repair of a Transannular Rupture During Transfemoral Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 14 ◽  
pp. 117954762110381
Author(s):  
Ryaan EL-Andari ◽  
Sabin J Bozso ◽  
Jimmy JH Kang ◽  
Vinod K Manikala ◽  
Michael C Moon ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Hybrid Operating Room ◽  
Transcatheter Aortic Valve ◽  
Acute Decompensation ◽  
Life Threatening ◽  
Midline Sternotomy

Annular rupture is a rare but life-threatening complication of transcatheter aortic valve replacement (TAVR). Mortality rates are high if immediate intervention, most often necessitating surgical repair, is not performed. Herein, we describe an 87-year-old man who, after deployment of TAVR, experienced acute decompensation and required urgent conversion to a midline sternotomy to repair an aortic annular rupture. This case demonstrates an example of a rare but severe complication of TAVR. This report provides an in-depth description of the surgical approach to repair an aortic annular rupture and demonstrates the utility of performing minimally invasive procedures inside a hybrid operating room.

Use and outcomes of emergency treatment strategies in patients with aortic valve stenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.M Piepenburg ◽  
K Kaier ◽  
C Olivier ◽  
M Zehender ◽  
C Bode ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Hospital Mortality ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Emergency Treatment ◽  
Funding Source ◽  
Artery Disease

Abstract Introduction and aim Current emergency treatment options for severe aortic valve stenosis include surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR) and balloon valvuloplasty (BV). So far no larger patient population has been evaluated regarding clinical characteristics and outcomes. Therefore we aimed to describe the use and outcome of the three therapy options in a broad registry study. Method and results Using German nationwide electronic health records, we evaluated emergency admissions of symptomatic patients with severe aortic valve stenosis between 2014 and 2017. Patients were grouped according to SAVR, TAVR or BV only treatments. Primary outcome was in-hospital mortality. Secondary outcomes were stroke, acute kidney injury, periprocedural pacemaker implantation, delirium and prolonged mechanical ventilation >48 hours. Stepwise multivariable logistic regression analyses including baseline characteristics were performed to assess outcome risks. 8,651 patients with emergency admission for severe aortic valve stenosis were identified. The median age was 79 years and comorbidities included NYHA classes III-IV (52%), coronary artery disease (50%), atrial fibrillation (41%) and diabetes mellitus (33%). Overall in-hospital mortality was 6.2% during a mean length of stay of 22±15 days. TAVR was the most common treatment (6,357 [73.5%]), followed by SAVR (1,557 [18%]) and BV (737 8.5%]). Patients who were treated with TAVR or BV were significantly older than patients with SAVR (mean age 81.3±6.5 and 81.2±6.9 versus 67.2±11.0 years, p<0.001), had more relevant comorbidities (coronary artery disease 52–91% vs. 21.8%; p<0.001), worse NYHA classes III-IV (55–65% vs. 34.5%; p<0.001) and higher EuroSCORES (24.6±14.3 and 23.4±13.9 vs. 9.5±7.6; p<0.001) than SAVR patients. Patients treated with BV only had the highest in-hospital mortality compared with TAVR or SAVR (20.9% vs. 5.1 and 3.5%; p<0.001). Compared with BV only, SAVR patients (adjusted odds ratio [aOR] 0.25; 95% confidence interval [CI] 0.14–0.46; p<0.001) and TAVR patients (aOR 0.37; 95% CI 0.28–0.50; p<0.001) had a lower risk for in-hospital mortality. Conclusion In-hospital mortality for emergency patients with symptomatic severe aortic valve stenosis is high. Our results showed that BV only therapy was associated with highest mortality, which is in line with current research. Yet, there is a trend towards more TAVR interventions and this study might imply that balloon valvuloplasty alone is insufficient. The role of BV as a bridging strategy to TAVR or SAVR needs to be further investigated. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany

scholarly journals Use of extracorporeal membrane oxygenation as a bridge to transcatheter aortic valve replacement in a patient with aortic stenosis and severe coronary artery disease: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Majid Ahsan ◽  
Rolf Alexander Jánosi ◽  
Tienush Rassaf ◽  
Alexander Lind
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Risk Patients ◽  
Artery Disease

Abstract Background Patients with severe aortic stenosis (AS) often present with multiple comorbidities and suffer from critical coronary artery disease (CAD). Transcatheter aortic valve replacement (TAVR) has become the therapy of choice for moderate to high-risk patients. Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) offers the possibility of temporary cardiac support to manage life-threatening critical situations. Case summary Here, we describe the management of a patient with severe AS and CAD with impaired left ventricular ejection fraction (LVEF). We used v-a-ECMO as an emergency strategy in cardiogenic shock during a high-risk coronary intervention to stabilize the patient, and as a further bridge to TAVR. Discussion Very high-risk patients with severe AS are unlikely to tolerate the added risk of surgical aortic valve replacement. Using ECMO may help them to benefit from TAVR as the only treatment option available.

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