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CASE REPORT article
Front. Cardiovasc. Med.
Sec. Structural Interventional Cardiology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1440231
Delayed Coronary Obstruction Leading to Death Following Balloon Dilation in Self-Expanding Aortic Valve for Acute Coronary Occlusion: A Case Report
Provisionally accepted- 1 The Second Affiliated Hospital of Harbin Medical University, Harbin, China
- 2 First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Background: Following transcatheter aortic valve replacement, acute coronary obstruction is infrequent but potentially life-threatening, while delayed coronary obstruction is even more uncommon.A 69-year-old male underwent TAVR and subsequently developed an acute obstruction in the left main coronary artery. Interventional management involved performing percutaneous transluminal coronary angioplasty using balloon dilation on both the left main coronary artery and its ostium. Intravascular ultrasound confirmed successful dilation of the coronary ostium.The patient experienced resolution of symptoms, and ventricular premature beats disappeared on electrocardiogram monitoring. However, the patient unfortunately succumbed to sudden death one month after discharge.Guidewires for chronic total occlusion may be necessary for patients with severely calcified and stenotic aortic valves that are challenging to navigate. Before undertaking TAVR, precise preoperative evaluation, including accurate risk assessment, multimodal imaging, and thorough planning, is essential. While balloon dilation can provide temporary relief for coronary obstruction, it carries the risk of subsequent delayed coronary occlusion with serious consequences.Chest pain experienced under local anesthesia more directly suggests coronary occlusion.
Keywords: TAVR1, aortic stenosis2, Coronary obstruction3, Delay Coronary obstruction4, Acute coronary occlusion5, case report6
Received: 30 May 2024; Accepted: 10 Feb 2025.
Copyright: © 2025 DongHui and Hao Ran. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhang DongHui, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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