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Main stem subocclusion shortly after aortic valve replacement
  1. G Van Langenhove,
  2. P Van den Heuvel,
  3. F Van den Branden
  1. Department of Cardiology, Middelheim Hospital, Lindendreef 1, 2020 Antwerp, Belgium
  1. Dr Van Langenhove.

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A 58 year old woman was referred to our centre for aortic valve replacement because of a severe symptomatic aortic stenosis. She had no coronary risk factors. Rest ECG showed complete left bundle branch block. Coronary angiography showed normal coronary anatomy (fig 1). The gradient over the aortic valve could not be measured because of repetitive iatrogenic induction of ventricular tachycardia on inserting the catheter into the left ventricle. Non-invasive evaluation showed an echo Doppler gradient of 70 mm Hg and an aortic valve area of 1.2 cm2 with normal left ventricular function. The patient was scheduled for aortic valve replacement.

Figure 1

Coronary angiography showing (A) normal main stem (left anterior oblique view); (B) main stem stenosis (left anterior oblique view); (C) …

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