Key result
Repeat chimney stenting successfully treats delayed coronary occlusion occurring months after TAVR.
Why the study?
Delayed coronary artery occlusion is a rare but fatal complication after transcatheter aortic valve replacement, and data on delayed CAO despite chimney stenting are limited.
Case Report (n=1)
No
This case highlights that delayed coronary artery occlusion can still occur months after TAVR despite initial protection with chimney stenting.
Clinicians should remain vigilant for late occlusion after TAVR chimney stenting; case report leaves open optimal surveillance and prevention strategies.
BACKGROUND: Delayed coronary artery occlusion (CAO) is a rare but fatal complication after transcatheter aortic valve replacement, chimney stenting is the standard technique for established CAO or impending CAO. CASE PRESENTATION: We describe a female patient who developed non-ST elevation myocardial infarction after receiving transcatheter aortic valve replacement and chimney stenting 4 months prior. An angiogram revealed delayed coronary artery occlusion with a deformed stent, which was never reported. This patient was subsequently treated with a new chimney stent. CONCLUSIONS: For self-expanding valves, the coronary ostium is protected by chimney stenting, delayed coronary artery occlusion can occur and cause catastrophic complications.
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Li et al. (2021) conducted a case report in Severe coronary heart disease and aortic valve stenosis (n=1). Transcatheter aortic valve replacement and chimney stenting was evaluated on Delayed coronary artery occlusion. Delayed coronary artery occlusion can occur months after transcatheter aortic valve replacement and chimney stenting, requiring re-intervention with a new chimney stent.
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