Key result
Stentless valve replacement resolves immediate occlusive left main thrombosis following stented AVR.
Why the study?
Immediate thrombosis of the left main stem after aortic valve replacement in patients with paracommissural slit-like coronary ostia is a rare and serious complication.
Case Report (n=1)
Highlights a rare case of immediate left main stem thrombosis following aortic valve replacement in a patient with paracommissural slit-like coronary ostia, successfully managed by switching to a stentless valve.
Rare slit-like ostia may precipitate post-AVR occlusion and VT; leaves open whether preoperative imaging improves safety.
We describe a clinical case of 73-year-old woman with severe aortic stenosis and no coronary artery disease, who underwent elective aortic valve replacement with a stented pericardial tissue prosthesis.The presence of paracommissural slit-like coronary ostia was noted as an occasional anatomic abnormality on the surgical inspection of the aortic root.The patient presented ventricular tachycardia episode during the transfer to the intensive care unit.Upon an emergent re-sternotomy, occlusive thrombosis of the left main stem was revealed.The stented aortic valve prosthesis was replaced by a stentless pericardial valve.The postoperative course was uneventful.
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Daniyar Gilmanov (2016) conducted a case report in Severe aortic stenosis (n=1). Aortic valve replacement with a stented pericardial tissue prosthesis was evaluated. A 73-year-old woman developed immediate occlusive thrombosis of the left main stem after aortic valve replacement with a stented pericardial tissue prosthesis, successfully treated by replacing it with a stentless valve.
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