title: Right coronary occlusion following transcatheter aortic valve implantation: two case reports.
abstract: This paper discusses two male patients with severe aortic stenosis, whose right coronary arteries (RCA) were completely occluded during transcatheter aortic valve implantation (TAVI), leading to fatal hemodynamic disorder. Occlusions of RCA complicated by TAVI are rare. In addition, emergency cardiopulmonary bypass (CPB) played a critical role in rescuing our second patient. Both patients were admitted for "severe aortic stenosis," and TAVIs were performed. The first patient's blood pressure immediately dropped to 70/40 mmHg after the balloon expansion and did not increase much after the administration of aramine or fluid therapy. He did not receive emergency surgery and died after 1.5 h of resuscitation. The second patient's blood pressure fluctuated greatly for several minutes after the valve implantation, ranging from 170/100 mmHg to 60/40 mmHg. Angiography revealed a total occlusion of RCA. Thoracic surgery with CPB was performed, and the patient survived.
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Luo
authors.affiliation: Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China. grace_chenguo@hotmail.com.
authors.forename: Guo
authors.initials: G
authors.lastname: Chen
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: aortic stenosis; cardiac group; right coronary occlusion; transcatheter aortic valve implantation