title: Left main coronary artery obstruction by dislodged native-valve calculus after transcatheter aortic valve replacement.
abstract: Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement.
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Tahir
authors.initials: T
authors.lastname: Durmaz
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Ayhan
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Telat
authors.initials: T
authors.lastname: Keles
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Abdullah Nabi
authors.initials: AN
authors.lastname: Aslan
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Kemal Esref
authors.initials: KE
authors.lastname: Erdogan
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Cenk
authors.initials: C
authors.lastname: Sari
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Bilen
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Akcay
authors.affiliation: Department of Cardiology (Drs. Akcay, Ayhan, Bozkurt, Durmaz, and Keles), Faculty of Medicine, Yildirim Beyazit University; and Departments of Cardiology (Drs. Aslan, Bilen, and Sari) and Cardiovascular Surgery (Dr. Erdogan), Ankara Ataturk Education and Research Hospital, 06800 Ankara, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Bozkurt
mesh_terms: D000368:Aged; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D002137:Calculi / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017548:Echocardiography, Transesophageal; D017809:Fatal Outcome; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D062645:Percutaneous Coronary Intervention; D011474:Prosthesis Design; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
keywords: Aortic valve stenosis/therapy; calcinosis/complications; coronary occlusion/etiology; fatal outcome; heart valve prosthesis implantation/adverse effects/methods/mortality; risk assessment