This article presented the clinical diagnosis and management of a patient with severe aortic regurgitation and moderate aortic stenosis who underwent transcatheter aortic valve replacement complicated with coronary obstruction and retroperitoneal hematoma. The hemodynamics collapsed during the procedure, and transcatheter aortic valve replacement was performed under support of extracorporeal membrane oxygenation and coronary protection. After a negative coronary angiography, the wire was extracted, but a repeated angiography showed left coronary obstruction, so a coronary stent was implanted to the ostium of left coronary artery through the grid of the valve stent. Abdominal CT showed a giant retroperitoneal hematoma 2 weeks after transcatheter aortic valve replacement, and the emergent angiography indicated contrast leakage from left external iliac artery, so a balloon compression was performed followed by a covered stent implantation. This article also provided the clinical characteristics, risk factors and management of coronary obstruction and vascular complication for clinical reference.
Citation： SUN Yinghao, LI Jie, ZHENG Shengneng, FU Ming, LI Guang, FAN Ruixin, LUO Jianfang. Transcatheter aortic valve replacement complicated with coronary obstruction and retroperitoneal hematoma: a case report. West China Medical Journal, 2020, 35(9): 1131-1134. doi: 10.7507/1002-0179.202008032 Copy