Left Main Percutaneous Coronary Intervention and Transcatheter Aortic Valve Replacement in a Young Male with Rheumatic Heart Disease and Porcelain Aorta.

Vinod Chainani,Carlos E Alfonso,Patrick Hourani,Pedro Martinez-Clark,Pablo Rengifo-Moreno,Ram Hanno,Osman Perez

doi:10.1155/2016/3671923

Abstract

We highlight the presence of a calcified mass in the left main coronary artery without significant atherosclerosis seen in the other coronary arteries or in the peripheral large arteries. In our view, the calcified character of the obstruction and the calcification of the aortic valve are characteristic of a variant type of coronary artery disease (CAD) not associated with the same risk factors as diffuse coronary atherosclerosis, but, in this case, with rheumatic heart disease. This case report also emphasizes the interventional approach for patients with aortic valve stenosis secondary to rheumatic heart disease.

Highlights

Far from eradicated, after more than two hundred years since William Charles Wells linked acute rheumatic fever with carditis, rheumatic heart disease continues to be a disease of global proportions
This case highlights the presence of a calcified mass in the left main coronary artery (LMCA) without significant atherosclerosis seen in the other coronary arteries or in the peripheral large arteries
The calcified character of the obstruction and the calcification of the aortic valve are characteristic of a variant type of coronary artery disease (CAD) not associated with the same risk factors as diffuse coronary atherosclerosis, but, in this case, with rheumatic heart disease [2]

Summary

Introduction

Far from eradicated, after more than two hundred years since William Charles Wells linked acute rheumatic fever with carditis, rheumatic heart disease continues to be a disease of global proportions. In a recent extensive literature review by Carapetis and colleagues, it was estimated that there are over 15.6 million people affected by rheumatic heart disease globally with a reported 233,000 deaths annually [1]. We present the case of a young male with a variant type of coronary artery disease not associated with the typical risk factors for heart disease but with a prior history of rheumatic fever

Case Presentation

Findings

Discussion