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Case Reports
. 2014 Aug 22;10(6):213-215.
doi: 10.1016/j.jccase.2014.07.013. eCollection 2014 Dec.

Aortic valve replacement in patients with protruding coronary artery stents

Masaki Nakamura  1 , Kenji Minakata  1 , Kazuhiro Yamazaki  1 , Takeichiro Nakane  1 , Shinichi Tsumaru  1 , Eiji Yoshikawa  1 , Hisashi Sakaguchi  1 , Akira Marui  1 , Ryuzo Sakata  1
Affiliations
Case Reports

Aortic valve replacement in patients with protruding coronary artery stents

Masaki Nakamura et al. J Cardiol Cases. .

Abstract

We present two cases of aortic valve replacement (AVR) in patients with protruding coronary artery stents from the coronary ostia. In the first case, an 87-year-old female was referred for AVR due to severe aortic stenosis (AS). During the operation, we found stents protruding from the left and the right coronary ostia into the aortic root. We performed AVR with a mechanical valve and coronary artery bypass grafting with the saphenous vein to the left anterior descending artery. In the second case, a 77-year-old female was referred for AVR due to severe AS with a history of healed infective endocarditis. During surgery on the second patient, we found a stent protruding 7 mm from the left coronary ostium into the aortic root. The edge of the stent was trimmed, and AVR with a mechanical valve was performed. In both patients, we decided to use a mechanical prosthesis instead of a bioprosthesis because of the risk of leaflet injury. Herein, we discuss some issues regarding patients with AS requiring AVR with prior history of coronary stenting in the coronary ostia. <Learning objective: To explore the problem of coronary stents protruding into the ostia in cases of percutaneous coronary intervention of left main or right proximal lesions, which can compromise subsequent aortic valve procedures including surgical aortic valve replacement or even transcatheter aortic valve replacement thereafter.>.

Keywords: Aortic valve replacement; Percutaneous coronary intervention; Stent protrusion; Valve prosthesis.

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Figures

Fig. 1
Fig. 1
Left: coronary angiography showed a stent implanted in the left main trunk. Right: in the first case, an intraoperative photograph shows the stents protruding from the left and the coronary ostia.
Fig. 2
Fig. 2
Left: coronary angiography shows a stent placed in the left main trunk. Right: in the second case, an intraoperative photograph shows the stent protruding from the left coronary ostium.
See this image and copyright information in PMC

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