Author + information
- Received August 16, 2011
- Accepted September 15, 2011
- Published online May 1, 2012.
- Gonzalo Barge-Caballero, MD,
- Manuel López-Pérez, MD,
- Alberto Bouzas-Mosquera, MD,
- Ramón Fábregas-Casal, MD,
- Nemesio Álvarez-García, MD,
- Eduardo Barge-Caballero, MD, PhD,
- Jorge Salgado-Fernández, MD,
- Nicolás Vázquez-González, MD and
- Alfonso Castro-Beiras, MD, PhD
An 86-year-old man with severe aortic stenosis and preserved left ventricular ejection fraction was referred for percutaneous aortic valve replacement. Pre-procedural coronary angiography showed normal coronary arteries.
After percutaneous aortic balloon valvuloplasty, the peak-to-peak aortic valve gradient fell from 80 to 40 mm Hg. A 23-mm Edwards SAPIEN transcatheter aortic prosthetic valve (Edwards Lifesciences, Irvine, California) was then deployed (A, Online Video 1). After this procedure, the patient developed profound hemodynamic instability. Transesophageal echocardiography showed severe left ventricular systolic dysfunction with extensive anterolateral akinesia (B and C, Online Video 2).
Coronary angiography demonstrated an acute occlusion of the left main coronary artery secondary to the displacement of the native calcified left coronary cusp (B and C, Online Videos 3 and 4). Percutaneous coronary intervention with bare-metal stent implantation was performed (D), restoring normal epicardial blood flow (E and F, Online Videos 5 and 6). Transesophageal echocardiography confirmed the recovery of the left ventricular contractility (F, Online Video 7).
- Received August 16, 2011.
- Accepted September 15, 2011.
- American College of Cardiology Foundation