title: Cardiac computed tomography in the management of iatrogenic coronary ostial stenosis after aortic valve replacement.
abstract: Although rare, iatrogenic coronary ostial stenosis is an important complication of aortic valve replacement and Bentall procedure. We report a 32-year-old male presenting an acute coronary syndrome post-Bentall procedure and the role of computed tomography in diagnosis and management of iatrogenic coronary ostial stenosis. Such occlusions are commonly identified in the left main coronary artery, but can develop in venous bypass grafts at anastomoses with Dacron aortic grafts. Cardiac computed tomography is valuable to exclude noncoronary causes of chest pain, assess ostial stenosis of manipulated arteries post reimplantation, and shed light on mechanisms and management of these lesions.
authors.affiliation: Department of Cardiology, Prairie Vascular Research Network, University of Saskatchewan, Regina, Saskatchewan, Canada. payamde@gmail.com
authors.forename: Payam
authors.initials: P
authors.lastname: Dehghani
authors.forename: Tom
authors.initials: T
authors.lastname: Elliott
authors.forename: Lanna
authors.initials: L
authors.lastname: Olson
authors.forename: Stephen
authors.initials: S
authors.lastname: Korkola
authors.forename: Paul
authors.initials: P
authors.lastname: Schulte
authors.forename: Greg
authors.initials: G
authors.lastname: Kraushaar
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods; D002637:Chest Pain / Q000175:diagnosis / Q000209:etiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome