CC BY-NC-ND 4.0 · Avicenna J Med 2016; 06(03): 86-88
DOI: 10.4103/2231-0770.184069

Recurrent angina from chronic coronary obstruction following transcatheter aortic valve implantation

Mohamad Kabach
Department of Internal Medicine, University of Miami Miller Palm Beach Regional Campus, Atlantis, Florida, USA
Abdulah Alrifai
Department of Internal Medicine, University of Miami Miller Palm Beach Regional Campus, Atlantis, Florida, USA
Stefanie Furlan
Department of Internal Medicine, University of Miami Miller Palm Beach Regional Campus, Atlantis, Florida, USA
Fares Alahdab
Mayo Evidence based Practice Center, Mayo Clinic, Rochester, MN, USA
› Author Affiliations
Financial support and sponsorship Nil.


Severe aortic stenosis and coronary artery disease often coexist. Coronary angiography (CA) and percutaneous coronary intervention (PCI) can be challenging in patients with prior transcatheter aortic valve implantation (TAVI). Depending on the type and position of the implanted valve, the procedure can be challenging or even unfeasible due to interference of diagnostic catheters and valve parts. The correct positioning of the TAVI prosthesis during TAVI was identified as an important factor with regard to the feasibility of subsequent CA or PCI. TAVI has been also associated with vascular, cerebrovascular and conduction complication. One is rare but life-threatening complication, coronary ostial obstruction. Coronary ostial obstruction can develop, especially if a safety check of more than 10 mm of coronary ostial height is not taken into consideration during TAVI. This complication can cause recurrent episodes of angina and can severely worsen the patient′s cardiac systolic function.

Publication History

Article published online:
09 August 2021

© 2016. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

  • References

  • 1 Rodés-Cabau J. Transcatheter aortic valve implantation: Current and future approaches. Nat Rev Cardiol 2011;9:15-29.
  • 2 Eltchaninoff H, Prat A, Gilard M, Leguerrier A, Blanchard D, Fournial G, et al. Transcatheter aortic valve implantation: Early results of the FRANCE (FRench Aortic National CoreValve and Edwards) registry. Eur Heart J 2011;32:191-7.
  • 3 Linke A, Wenaweser P, Gerckens U, Tamburino C, Bosmans J, Bleiziffer S, et al. Treatment of aortic stenosis with a self-expanding transcatheter valve: the International Multi-centre ADVANCE Study. Eur Heart J 2014;35:2672-84. doi: 10.1093/eurheartj/ehu162.
  • 4 Ribeiro HB, Nombela-Franco L, Urena M, Mok M, Pasian S, Doyle D, et al. Coronary obstruction following transcatheter aortic valve implantation: A systematic review. JACC Cardiovasc Interv 2013;6:452-61.
  • 5 Holmes DR Jr., Mack MJ, Kaul S, Agnihotri A, Alexander KP, Bailey SR, et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol 2012;59:1200-54.
  • 6 Masson JB, Kovac J, Schuler G, Ye J, Cheung A, Kapadia S, et al. Transcatheter aortic valve implantation: Review of the nature, management, and avoidance of procedural complications. JACC Cardiovasc Interv 2009;2:811-20.
  • 7 Blumenstein J, Kim WK, Liebetrau C, Gaede L, Kempfert J, Walther T, et al. Challenges of coronary angiography and intervention in patients previously treated by TAVI. Clin Res Cardiol 2015;104:632-9.