Management of significant left main coronary disease before and after trans-apical transcatheter aortic valve replacement in a patient with severe and complex arterial disease

Catheter Cardiovasc Interv. 2013 Sep 1;82(3):E262-5. doi: 10.1002/ccd.24865. Epub 2013 Mar 16.

Abstract

We report the case of an 81-year-old woman with symptomatic severe aortic stenosis, extremely significant peripheral arterial disease, and obstructive coronary artery disease who underwent percutaneous coronary intervention via a transaxillary conduit immediately before a trans-apical transcatheter aortic valve replacement performed with a transfemoral device. After deployment of the transcatheter heart valve, there was a left main coronary obstruction and the patient required an emergent PCI. This multifaceted case clearly underlines the importance of a well functioning heart team including the interventional cardiologist, the cardiovascular surgeon, and the echocardiographer.

Keywords: left main coronary disease; peripheral vascular disease; valvular heart disease.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / therapy*
  • Cardiac Catheterization*
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / therapy*
  • Emergencies
  • Female
  • Femoral Artery
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Patient Care Team
  • Percutaneous Coronary Intervention*
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / diagnosis
  • Severity of Illness Index
  • Treatment Outcome