To Be Removed or Not? Intraoperative Transesophageal Echocardiography Evaluation of Coronary Ostial Stent Protruding Into the Aorta

      ONGOING TECHNOLOGIC advancements in percutaneous coronary intervention for coronary artery disease have given rise to an increasing number of coronary ostial interventions for coronary artery disease.
      • Corda DM
      • Dragstedt C
      • Allen GS
      • et al.
      Protruding coronary stent detected by transesophageal echocardiography changes surgical procedure.
      • Nakamura M
      • Minakata K
      • Yamazaki K
      • et al.
      Aortic valve replacement in patients with protruding coronary artery stents.
      • Uehara Y
      • Shimizu M
      • Yoshimura M.
      A novel technique for catheter engagement of protruding aorto-ostial stent.
      The management of a protruding stent detected during cardiac surgery has been variable.
      • Nakamura M
      • Minakata K
      • Yamazaki K
      • et al.
      Aortic valve replacement in patients with protruding coronary artery stents.
      ,
      • Erez E
      • Herz I
      • Snir E
      • et al.
      Surgical removal of stent entrapped in proximal left coronary artery system.
      ,
      • Nwaejike N
      • Rozario C
      • Sogliani F.
      Management of a protruding right coronary artery stent during aortic valve replacement for aortic stenosis.
      The authors here report two patients in whom previously inserted coronary ostial stents protruding into the aorta were evaluated by intraoperative transesophageal echocardiography (TEE) during cardiac surgery. The possible factors that guide the nature of intervention in such situations are also discussed.

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      References

        • Corda DM
        • Dragstedt C
        • Allen GS
        • et al.
        Protruding coronary stent detected by transesophageal echocardiography changes surgical procedure.
        Echocardiography. 2017; 34: 1385-1387
        • Nakamura M
        • Minakata K
        • Yamazaki K
        • et al.
        Aortic valve replacement in patients with protruding coronary artery stents.
        J Cardiol Cases. 2014; 10: 213-215
        • Uehara Y
        • Shimizu M
        • Yoshimura M.
        A novel technique for catheter engagement of protruding aorto-ostial stent.
        Catheter Cardiovasc Interv. 2014; 83: 1093-1096
        • Erez E
        • Herz I
        • Snir E
        • et al.
        Surgical removal of stent entrapped in proximal left coronary artery system.
        Ann Thorac Surg. 1996; 62: 884-885
        • Nwaejike N
        • Rozario C
        • Sogliani F.
        Management of a protruding right coronary artery stent during aortic valve replacement for aortic stenosis.
        Innovations (Phila). 2012; 7: 213-216
        • Villa E
        • Pacini D
        • Loforte A
        • et al.
        Protruding coronary stent.
        Eur J Cardiothorac Surg. 2005; 27: 712
        • Wintzer-Wehekind J
        • Larose E
        • Rodés-Cabau J
        • et al.
        Coronary stent protruding in the ascending aorta: Multimodality imaging evaluation.
        JACC Cardiovasc Interv. 2020; 13: 263-264
        • Lerner AB
        • Subramaniam B
        • Mahmood F
        • et al.
        An unusual echodensity in the ascending aorta: transesophageal echocardiographic visualization of a protruding coronary stent.
        Anesth Analg. 2006; 103: 854-855
        • Mamopoulos AT
        • Nowak T
        • Klues H
        • et al.
        Late coronary ostial stent fracture and embolism causing an acute thrombotic occlusion of the carotid artery with cerebral infarction.
        Circ Cardiovasc Interv. 2012; 5 (e-76-8)
        • Kang S-J
        • Ahn J-M
        • Kim W-J
        • et al.
        Intravascular ultrasound assessment of drug-eluting stent coverage of the coronary ostium and effect on outcomes.
        Am J Cardiol. 2013; 111: 1401-1407
        • Nixdorff U
        • Erbel R
        • Rupprecht HJ
        • et al.
        Noninvasive visualization of an apparent patent intracoronary stent by transesophageal echocardiography.
        Echocardiography. 1995; 12: 391-395
        • Kasprzak JD
        • Drożdż J
        • Peruga JZ
        • et al.
        Definition of Flow parameters in proximal nonstenotic coronary arteries using transesophageal doppler echocardiography.
        Echocardiography. 2000; 17: 141-150