Successful percutaneous management of left main trunk occlusion during percutaneous aortic valve replacement

Catheter Cardiovasc Interv. 2009 Jun 1;73(7):966-72. doi: 10.1002/ccd.21867.

Abstract

Transcatheter aortic valve replacement with balloon-expandable and self-expandable stent valves is available in Europe. The balloon-expandable valve is currently being investigated in a randomized trial in the US. We report an uncommon complication of left main trunk occlusion with balloon-expandable valve deployment and its successful percutaneous management. Left main trunk occlusion was immediately recognized when patient did not recover blood pressure after valve deployment. TandemHeart support was used to stabilize the patient immediately and left main trunk was successfully stented. Analysis of anatomy leading to this complication and potential measures to predict and prevent such a complication are discussed in this report.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / therapy*
  • Blood Pressure
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / instrumentation
  • Catheterization / adverse effects*
  • Catheterization / instrumentation
  • Coronary Occlusion / diagnosis
  • Coronary Occlusion / etiology
  • Coronary Occlusion / therapy*
  • Coronary Stenosis / complications
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / therapy*
  • Echocardiography, Doppler, Color
  • Echocardiography, Transesophageal
  • Female
  • Heart Valve Prosthesis
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / instrumentation
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Prosthesis Design
  • Radiography, Interventional
  • Stents
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Interventional