Page 38 - Journal of Structural Heart Disease Volume 5, Issue 2

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Case Report
struction. In our presented case, however, it is likely this would not have prevented the initial obstruction as the bioprosthetic valve strut was positioned at the ostium of the left main, and as such lacerating, the leaflet would likely not have prevented obstruction of the coronary ostium.
Conclusion
Given that the incidence of coronary artery disease in patients undergoing aortic valve replacement is as high as 30-50%, coronary intervention after TAVR is a relatively common and necessary procedure that has been demonstrated to be feasible [11]. With that in mind, this case presents a unique example of inter- vention in a “snorkeled” LM stent. While prevention
of coronary obstruction during TAVR is the goal, PCI bailout is a reasonable strategy that should be con- sidered and prepared for ahead of time in high-risk patients. Although challenging, reengagement and retreatment of such a “snorkeled” stent is feasible. However, the long-term outcomes of such interven- tions remain uncertain and will require further study.
Conflict of Interest
The authors have no conflict of interest relevant to this publication.
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Cite this article as: El-Haddad H, Re- sar J. Stenting the Snorkel: PCI of a Restenosed Left Main Stent Placed for Coronary Obstruction after Valve in Valve TAVR. Structural Heart Dis- ease. 2019;5(2):48-51. DOI: https://doi. org/10.12945/j.jshd.2019.030.18
El-Haddad H. et al.
Repeat PCI of a Post TAVR Left Main Snorkel Stent