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Journal of Medical Case Reports

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Open Access 01-12-2018 | Case report

Sudden death after valve-in-valve procedure due to delayed coronary obstruction: a case report

Authors: Angelo Buscaglia, Giacomo Tini, Gian Paolo Bezante, Claudio Brunelli, Manrico Balbi

Published in: Journal of Medical Case Reports | Issue 1/2018

Abstract

Background

Valve-in-valve transcatheter aortic valve implantation for degenerated aortic bioprostheses is an effective option for patients at high risk for redo surgery, even if it may be burdened by complications more common in specific settings, such as, coronary artery obstruction.

Case presentation

We present the case of a Caucasic 84-year-old woman with degeneration of a previously implanted aortic Mitroflow bioprosthesis. She underwent a valve-in-valve transcatheter aortic valve implantation with a CoreValve® bioprosthesis. End-procedure coronary angiography demonstrated maintained perfusion of both coronary arteries. However, few hours later, she experienced sudden cardiac death. An autopsy showed that Mitroflow prosthesis leaflets were higher than the left main coronary ostium, and no other possible cause for the sudden death. Fatality was thus ascribed to left main coronary ostium obstruction due to apposition of the Mitroflow leaflet pushed upward by the late expansion of CoreValve®.

Conclusions

Coronary artery obstruction is a frequently fatal complication which usually presents just after valve implantation, but, as reported in our case, it may also have a delayed presentation. Accurate patient’s selection and intraoperative preventive measures can reduce this eventuality.

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Title: Sudden death after valve-in-valve procedure due to delayed coronary obstruction: a case report
Authors: Angelo Buscaglia
Giacomo Tini
Gian Paolo Bezante
Claudio Brunelli
Manrico Balbi
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Journal of Medical Case Reports / Issue 1/2018
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-018-1785-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Sudden death after valve-in-valve procedure due to delayed coronary obstruction: a case report

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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