Coronary Obstruction Following Transcatheter Aortic Valve\nImplantation
A 82-year-old female, hypertensive and diabetic, in clinical evaluation due to\nfunctional class II (NYHA) heart failure, was diagnosed with significant aortic\nstenosis (mean gradient: 68 mmHg; valve area: 0.60 cm2). Based on her age\nand high risk (logistic EuroSCORE: 13.3%; STS-PROM: 14.8%), the patient was referred\nto transfemoral TAVI, with implantation of a 23 mm Sapien XT prosthesis. Immediately\nafter valve implantation, the patient developed severe and maintained hypotension,\nwithout electrocardiographic changes. Control aortography showed complete obstruction\nof LM ostium (). Drug-eluting stent\nimplantation in the LM was performed with restoration of coronary flow and immediate\nreversal of shock condition (). After\nthe procedure, however, a severe stroke was detected, with development of pneumonia\nand death after 78 days of hospitalization.