Management of left main coronary artery obstruction after transcatheter aortic valve replacement utilizing a periscope approach

Catheter Cardiovasc Interv. 2018 Dec 1;92(7):1444-1448. doi: 10.1002/ccd.27317. Epub 2017 Sep 20.

Abstract

Coronary obstruction is a rare but potentially fatal complication of transcatheter aortic valve replacement (TAVR). It can result from native leaflet or stent frame obstruction of the coronary ostia. There are reports detailing the difficulty of percutaneous coronary intervention following TAVR, but none that describe a periscope approach to access the left main ostia in the presence of a braided nitinol frame. This report describes an alternative approach to access a coronary artery when the valve stent struts are prohibitive to equipment delivery.

Keywords: left main; percutaneous coronary intervention; stent; transcatheter aortic valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Alloys
  • Angioplasty, Balloon, Coronary / instrumentation
  • Angioplasty, Balloon, Coronary / methods*
  • Aortic Valve Stenosis / surgery*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / etiology
  • Coronary Stenosis / therapy*
  • Female
  • Heart Valve Prosthesis
  • Humans
  • Prosthesis Design
  • Severity of Illness Index
  • Stents
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Transcatheter Aortic Valve Replacement / instrumentation
  • Treatment Outcome

Substances

  • Alloys
  • nitinol