Left Coronary Artery Occlusion After Percutaneous Pulmonary Valve Implantation Daniel Biermann, MD, Jeanette Schönebeck, MD, Marcus Rebel, MD, Jochen.

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Presentation transcript:

Left Coronary Artery Occlusion After Percutaneous Pulmonary Valve Implantation Daniel Biermann, MD, Jeanette Schönebeck, MD, Marcus Rebel, MD, Jochen Weil, MD, PhD, Ali Dodge-Khatami, MD, PhD The Annals of Thoracic Surgery Volume 94, Issue 1, Pages e7-e9 (July 2012) DOI: 10.1016/j.athoracsur.2012.01.022 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 After inflating the sizing balloon, left anterior descending artery filling was determined to be adequate, and it was judged safe to proceed with the Melody valve insertion. The Annals of Thoracic Surgery 2012 94, e7-e9DOI: (10.1016/j.athoracsur.2012.01.022) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Same sequence after balloon sizing from a lateral view demonstrating the safe distance between the left anterior descending artery and future Melody valve. The Annals of Thoracic Surgery 2012 94, e7-e9DOI: (10.1016/j.athoracsur.2012.01.022) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Selective injection of the right coronary artery illustrating the anomalous circumflex origin from this vessel and right coronary dominance, which proved life saving. The Annals of Thoracic Surgery 2012 94, e7-e9DOI: (10.1016/j.athoracsur.2012.01.022) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Selective coronary angiography after discharge and subsequent readmission for crushing chest pain with confirmed occlusion of the left anterior descending artery behind the prestented Melody valve. The Annals of Thoracic Surgery 2012 94, e7-e9DOI: (10.1016/j.athoracsur.2012.01.022) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Coronary angiography 1 month after the salvage operation revealing an unobstructed left anterior descending artery. The Annals of Thoracic Surgery 2012 94, e7-e9DOI: (10.1016/j.athoracsur.2012.01.022) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions