title: Iatrogenic coronary ostial stenosis of left main stem following aortic valve replacement: visualization with optical coherence tomography.
abstract: Iatrogenic coronary ostial stenosis following aortic valve replacement (AVR) occurs in up to 3.4% of cases and usually presents within the first 6months following surgery. We present the case of an 85year old man who developed an acute coronary syndrome 2months following AVR. Coronary angiography revealed a severe de novo lesion in the left main stem, which, on optical coherence tomography, was shown to be due to severe intimal hyperplasia. The most likely underlying mechanism is vessel wall trauma caused by the rigid tip cannula used for administration of cardioplegia solution. Surgeons should be aware of this possibility when administering this solution via the antegrade approach.
authors.affiliation: Department of Cardiology, Manchester Heart Centre, Manchester Royal Infirmary, M13 9WL Manchester, United Kingdom.
authors.forename: Muhammad A
authors.initials: MA
authors.lastname: Khan
authors.forename: Francesco
authors.initials: F
authors.lastname: Prati
authors.forename: Magdi
authors.initials: M
authors.lastname: El-Omar
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000601:surgery*; D062906:Cardiac Catheters; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D054855:Drug-Eluting Stents; D004867:Equipment Design; D006324:Heart Arrest, Induced / Q000009:adverse effects / Q000295:instrumentation; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
keywords: Iatrogenic coronary ostial stenosis; Optical Coherence Tomography