[Right Coronary Artery Stenosis Demonstrated a Few Hours After Surgical Aortic Valve Replacement: Report of a Case].
Daigo ShinodaAtsushi MiyagawaNobu YokoyamaKoichi YuriPublished in: Kyobu geka. The Japanese journal of thoracic surgery (2024)
Some cases of coronary artery occlusion by prosthetic valves after surgical aortic valve replacement (SAVR) may be diagnosed and treated during operation if it is difficult to be separated from cardiopulmonary bypass. We present a case of a 74-year-old woman with symptomatic aortic stenosis due to bicuspid valve and a narrow aortic valve annulus. SAVR was considered to be feasible over transcatheter aortic valve implantation given her anatomy and frailty. A few hours after successful SAVR using a 19 mm bioprosthetic valve, she became hemodynamically unstable in the intensive care unit, and coronary angiography revealed severe stenosis at the right coronary artery orifice. Percutaneous coronary intervention was deemed technically demanding, and she subsequently underwent coronary artery bypass grafting. On the 35th postoperative day, the patient was transferred to another facility for rehabilitation. Two years after surgery, she has no chest symptoms and constantly visits the outpatient clinic by herself.
Keyphrases
- aortic valve
- aortic valve replacement
- aortic stenosis
- coronary artery
- transcatheter aortic valve implantation
- coronary artery bypass grafting
- percutaneous coronary intervention
- transcatheter aortic valve replacement
- pulmonary artery
- coronary artery disease
- st segment elevation myocardial infarction
- st elevation myocardial infarction
- acute coronary syndrome
- acute myocardial infarction
- antiplatelet therapy
- ejection fraction
- left ventricular
- patients undergoing
- early onset
- atrial fibrillation
- mitral valve
- long term care
- sleep quality
- single cell
- drug induced
- pulmonary hypertension