Document Detail

Distal left anterior descending coronary artery obstruction: a rare complication of transapical aortic valve implantation.
MedLine Citation:
PMID:  22147409     Owner:  NLM     Status:  In-Data-Review    
Apical complications are considered the "Achilles' heel" of transapical aortic valve implantation, in which laceration and hemorrhage are potentially fatal. We describe the case of a rare complication of the transapical aortic valve implantation procedure, where after apical closure, tension on a distal coronary segment resulted in flow obstruction. Clinicians should be alert to the possibility of distal left anterior descending artery obstruction when ischemia following a transapical procedure is suspected. The exact location of sheath insertion during "transapical" aortic valve implantation is usually apicolateral. A more apical insertion should be avoided since the apex is a relatively weak region and there could be an increased risk of coronary avulsion or apical ventricular septal defect. Nevertheless, a too-lateral insertion could diminish the sheath orientation toward the left ventricular outflow tract and the sheath could also be entrapped with mitral valve chordae. Surgeons should be aware of these factors when deciding on the exact sheath insertion site during tranaspical procedures.
Danny Dvir; Abid Assali; Eyal Porat; Ran Kornowski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  23     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E281-3     Citation Subset:  IM    
Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel.
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