Key result
Percutaneous coronary intervention with stenting successfully treated iatrogenic coronary ostial stenosis in 3 patients following aortic valve replacement, with good medium-term clinical outcomes.
Why the study?
Does percutaneous coronary intervention (PCI) with stenting improve clinical outcomes in patients with iatrogenic coronary ostial stenosis after aortic valve replacement?
Case Report (n=3)
No
Does percutaneous coronary intervention (PCI) with stenting improve clinical outcomes in patients with iatrogenic coronary ostial stenosis after aortic valve replacement?
PCI with stenting is a feasible and effective alternative to re-operation for treating iatrogenic coronary ostial stenosis following aortic valve replacement.
May support PCI stenting as alternative to reoperation; leaves open need for larger confirmatory studies.
BACKGROUND: Iatrogenic coronary ostial stenosis (ICOS) is a rare but potentially life-threatening complication of aortic valve replacement (AVR). This complication is usually diagnosed by angiography and treated with aortocoronary bypass surgery. CASE REPORTS: In the present 3 cases pre-operative coronary angiography confirmed normal coronary arteries and they underwent uncomplicated AVR. Coronary lesions were clinically manifest within 4 months after surgery, and repeat coronary angiography demonstrated bilateral ostial stenosis in 1 patient and left main trunk stenosis in the other 2. Two cases were detected by multidetector computed tomography (MDCT) before angiography. MDCT and Virtual Histology suggested fibrous tissue formation in the lesions. All 3 patients were successfully underwent percutaneous coronary intervention (PCI) and stenting. The post-procedure clinical course has been uneventful, except for elective stenting of a recurrent lesion in 1 asymptomatic patient. CONCLUSIONS: The incidence of ICOS after AVR is low. Noninvasive MDCT is useful for early diagnosis and PCI is a possible alternative treatment. ICOS may be caused by fibrous tissue formation, and therefore be distinct from conventional atherosclerosis.
No takes yet. Share an insight, caveat, or question.
Funada et al. (2006) conducted a case report in Iatrogenic coronary ostial stenosis after aortic valve replacement (n=3). Percutaneous coronary intervention (PCI) with stenting was evaluated on Procedural success and medium-term clinical outcome. Percutaneous coronary intervention with stenting successfully treated iatrogenic coronary ostial stenosis in 3 patients following aortic valve replacement, with good medium-term clinical outcomes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: