PMC3987397_01
Computed tomography with height measurement of coronary arteries in long-axis
view, showing right coronary artery (a) and left coronary artery (b). Sinus of
Valsalva measurement obtained from the mean between the larger and smallest
diameter on short-axis view (c). Aortography showing occlusion of right
coronary artery after transcatheter aortic valve implantation (d). Angiography
of right coronary artery after successful implantation of two stents (e).
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On angiotomography it was verified the sinus of Valsalva with mean diameter of 26 mm, valve annulus of 24 mm and height of right coronary artery (RCA) and left main (LM) of 10.4 mm and 9.6 mm, respectively (Figure 1). On aortography it was detected complete obstruction of RCA ostium (Figure 1). A condition of shock and cardiac arrest had quickly begun, so that cardiopulmonary resuscitation and angioplasty with implantation of 2 drug-eluting stent of the RCA were successfully performed (Figure 1).
PMC3987397_02
Aortography showing obstruction of the left main after transcatheter aortic
valve implantation (a), and angioplasty with stent implantation (b) showing
good final angiographic result (c).
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Control aortography showed complete obstruction of LM ostium (Figure 2). Drug-eluting stent implantation in the LM was performed with restoration of coronary flow and immediate reversal of shock condition (Figure 2).
PMC3987397_03