J Transcat Intervent.2020;28:eA20190029.
Iatrogenic left main and right coronary ostial occlusion following surgical aortic valve replacement
Alzira Nunes
, Paulo Araújo, Carlos Xavier Resende, Teresa Pinho, Paula Dias, Maria Júlia Maciel
DOI: 10.31160/JOTCI202028A20190029
ABSTRACT
Surgical aortic valve replacement is the gold standard for treatment of severe symptomatic aortic stenosis. Complications directly related to surgical procedure are relatively infrequent. Coronary ostial stenosis is a rare but potentially life-threatening complication, whose exact pathogenetic mechanism is not known, but a few hypotheses have been proposed. We present a case of a recurrent acute coronary syndrome during the first 12 months after simultaneous surgical aortic valve replacement and coronary artery bypass grafting, as a result of bilateral coronary ostial stenosis by prosthetic aortic valve. When this complication is suspected, especially in unstable patients, prompt diagnostic confirmation and early revascularization therapy are crucial. In this clinical setting, percutaneous intervention of coronary bypass emerged as the best revascularization option.
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