Los Angeles ? Kanye West’s mother most likely died of heart disease coupled with complications after plastic surgery, but the exact cause of death can’t be known, coroner’s officials said Thursday.

Donda West, 58, died Nov. 10 at a Los Angeles-area hospital, a day after she had breast reduction, tummy tuck and liposuction procedures.

A long autopsy report noted that West had coronary artery disease, including blockages of 50 percent to 70 percent in two arteries. The 5-foot-2-inch, 188-pound woman also was overweight and had developed several complications after surgery, including bronchopneumonia in one lung, according to the report.

The investigation found “therapeutic levels of medication” in West’s body but no unusually high levels and no internal bleeding.

“It is my opinion Ms. West died from some pre-existing coronary artery disease and multiple postoperative factors following surgery,” Dr. Louis A. Pena, a deputy medical examiner, stated in the report.

A representative for Kanye West declined to comment.

Asked whether Donda West would still be alive if she hadn’t undergone the elective procedures, Ed Winter, assistant chief of the Los Angeles County coroner’s office, said: “She could, possibly. But she could have also died because of pre-existing cardiac issues.”

Studies have shown serious complications from plastic surgery are rare, with death occurring in 1 in 58,810 procedures.

Dr. Jan Adams, who operated on West, has denied wrongdoing. Adams has repeatedly suggested other causes of death including heart attack, pulmonary embolism or accidental overdose of painkillers prescribed after the cosmetic surgery.

“The coroner’s report confirms what we have always believed. Until further discussion with the West family we have no additional comment,” Adams said in a statement e-mailed to The Associated Press.

According to West’s autopsy report, she underwent cosmetic surgery on Nov. 9 and went home that day, “even though she was advised that she receive postoperative care at another facility.”

Her first day home she was walking around and appeared fine, according to the autopsy report. She did complain of pain, including chest discomfort that coroner’s investigators said could have been caused by tight bandages on her torso, put there after surgery.

The next day she developed trouble breathing and died soon afterward. The report said the pneumonia could have restricted her breathing enough that the decreased oxygen supply to her heart triggered death.

A separate report by a coroner’s investigator said it couldn’t be determined whether West underwent any type of pre-surgical screening before her plastic surgery. She had a stress test in January 2007 after experiencing chest and shoulder pain, but those symptoms apparently never returned.

Two women who found West unresponsive on a bed in her home called 911, and on tapes released by authorities this month they told a dispatcher they believed she had suffered a heart attack. They tried unsuccessfully to revive her.