Three Cases of Iatrogenic Coronary Ostial Stenosis After Aortic Valve Replacement

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概要

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• Background Iatrogenic coronary ostial stenosis (ICOS) is a rare but potentially life-threatening complication of aortic valve replacement (AVR). This complication is usually diagnosed by angiography and treated with aortocoronary bypass surgery. Case Reports In the present 3 cases pre-operative coronary angiography confirmed normal coronary arteries and they underwent uncomplicated AVR. Coronary lesions were clinically manifest within 4 months after surgery, and repeat coronary angiography demonstrated bilateral ostial stenosis in 1 patient and left main trunk stenosis in the other 2. Two cases were detected by multidetector computed tomography (MDCT) before angiography. MDCT and Virtual Histology suggested fibrous tissue formation in the lesions. All 3 patients were successfully underwent percutaneous coronary intervention (PCI) and stenting. The post-procedure clinical course has been uneventful, except for elective stenting of a recurrent lesion in 1 asymptomatic patient. Conclusions The incidence of ICOS after AVR is low. Noninvasive MDCT is useful for early diagnosis and PCI is a possible alternative treatment. ICOS may be caused by fibrous tissue formation, and therefore be distinct from conventional atherosclerosis.

• 社団法人日本循環器学会の論文
• 2006-09-20

著者

• Shimizu Masami

  Cardiovascular Checkup Committee For School Pupils Of Kanazawa Medical Association

• Mizuno Sumio

  福井心臓血圧センター

• Mizuno Sumio

  金沢大学 循環器内科

• Shimizu Masami

  金沢大学 循環器内科

• Funada Akira

  Fukui Cardiovascular Center

• Mizuno Sumio

  Fukui Cardiovascular Center

• Ohsato Kazuo

  Fukui Cardiovascular Center

• Murakami Tatsuaki

  Fukui Cardiovascular Center

• Moriuchi Ikuo

  Fukui Cardiovascular Center

• Misawa Katsushi

  Fukui Cardiovascular Center

• Kokado Hiromasa

  Fukui Cardiovascular Center

• Shimada Yoshifumi

  Fukui Cardiovascular Center

• Ishida Kentarou

  Fukui Cardiovascular Center

• Ohashi Hirokazu

  Fukui Cardiovascular Center

• Ohosato Kazuo

  Fukui Cardiovascular Center

• Ohsato Kazuo

  Division Of Cardiology Fukui Cardiovascular Center

• Oe Kotaro

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Ohe Koutarou

  Fukui Cardiovascular Center

• Shimizu Masami

  Second Department Of Internal Medicine School Of Medicine Kanazawa University

• Shimizu Masami

  The Second Department Of Internal Medicine School Of Medicine Kanazawa University

• Murakami Tatsuaki

  Department Of Internal Medicine Fukui Cardiovascular Center

• Shimizu Masami

  The Second Department Of Internal Medicine School Of Medicine Kanazawa; University

• Shimizu Masami

  Department Of Internal Medicine Fukui Cardiovascular Center

• Shimizu Masami

  The Second Department Of Internal Medicine Kanazawa University Hospital

• Shimizu Masami

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Murakami Tatusaki

  福井循環器病院

• Murakami Tatsuaki

  福井循環器病院

• Murakami T

  福井循環器病院 循環器科

• Mizuno Sumio

  Division Of Cardiology Fukui Cardiovascular Center Hospital

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