Document Detail


Iatrogenic left main coronary ostial stenosis after a Bentall procedure in an asymptomatic young man.
MedLine Citation:
PMID:  22719152     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Coronary ostial stenosis is a rare but potentially fatal sequela of aortic surgery. The clinical presentation can include acute coronary syndromes, ventricular arrhythmias, congestive heart failure, or sudden death. Herein, we present what we believe is the first reported case of asymptomatic iatrogenic left main coronary ostial stenosis. The patient was an active 34-year-old man who had undergone a modified Bentall procedure and was asymptomatic thereafter. Seven months after that operation, exercise stress testing showed electrocardiographic signs of asymptomatic myocardial ischemia at high workload, and coronary angiography revealed severe nonatherosclerotic left main ostial stenosis. Percutaneous coronary intervention and stenting of the unprotected left main stenosis was successful, and patency at 8 months was apparent on coronary angiography.The conventional treatment for coronary ostial stenosis, coronary artery bypass grafting, carries a high risk of perioperative infarction, morbidity, and death. We found that percutaneous coronary intervention with stenting yielded positive short- and long-term results and may provide an alternative to cardiac surgery in these high-risk patients. We recommend that physicians evaluate even asymptomatic patients for left main coronary ostial stenosis after aortic surgery so that early diagnosis and treatment can avert severe clinical manifestations.
Authors:
Chiara Bernelli; Gian Paolo Bezante; Claudio Brunelli; Manrico Balbi
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  39     ISSN:  1526-6702     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-21     Completed Date:  2012-10-29     Revised Date:  2013-07-12    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-7     Citation Subset:  IM    
Affiliation:
Cardiology Unit, DIMI-Department of Internal Medicine, University of Genova, 16132 Genova, Italy. chiarabernelli@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / surgery*
Angioplasty, Balloon, Coronary / instrumentation
Aortic Aneurysm / surgery*
Asymptomatic Diseases
Blood Vessel Prosthesis Implantation / adverse effects*
Coronary Angiography
Coronary Stenosis / diagnosis,  etiology*,  therapy
Echocardiography, Stress
Electrocardiography
Exercise Test
Heart Valve Prosthesis Implantation / adverse effects*
Humans
Iatrogenic Disease*
Male
Stents
Treatment Outcome
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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