Key result
Immediate stenting rescues acute left main obstruction during TAVR, enabling discharge in ~4 days.
Why the study?
Coronary artery obstruction is a rare but potentially life-threatening complication during TAVR for severe aortic stenosis that requires prompt management.
Case Report (n=1)
Highlights the rare but life-threatening complication of coronary artery obstruction during TAVR and the importance of immediate recognition and percutaneous intervention.
Coronary obstruction remains a rare TAVR complication warranting preprocedural vigilance; leaves open optimal prevention strategies in severe calcific AS.
Transcatheter aortic valve replacement (TAVR) for the management of severe aortic stenosis (AS) has come a long way, from indicated in high surgical risk to low surgical risk. One of the rare but potentially life-threatening complications includes coronary artery obstruction. We present a case of 67-year-old female, who presented with acute congestive heart failure; 2d echocardiogram suggestive of severe calcific AS and global left ventricular (LV) hypokinesia with an ejection fraction of 20%–25%. After stabilization, she was taken for TAVR. Postvalve deployment left main coronary artery (LMCA) was obstructed by the bulky native aortic leaflet, leading to hemodynamic collapse. Patient was rescued with quick hooking, wiring, and stenting of the LMCA (hardware already available on the table). The patient was extubated the very next day and discharged after 4 days.
No takes yet. Share an insight, caveat, or question.
Agarwal et al. (2026) conducted a case report in Severe calcific aortic stenosis (n=1). Transcatheter aortic valve replacement (TAVR) and LMCA stenting was evaluated. Left main coronary artery obstruction during TAVR in a 67-year-old female was successfully rescued with immediate wiring and stenting, leading to discharge after 4 days.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: