Key result
Pericardial patch reconstruction and CABG effectively resolve severe iatrogenic aortic regurgitation after PCI.
Why the study?
Permanent aortic valve injury after PCI is a rare but catastrophic complication causing acute severe AR and heart failure, and literature on catheter-induced aortic valve injury is sparse.
Case Report (n=1)
Prompt echocardiography is critical to exclude rare iatrogenic aortic cusp laceration and severe aortic regurgitation in patients presenting with intractable pulmonary edema or cardiac decompensation following PCI.
Alerts to rare aortic valve injury in complex PCI; leaves optimal prevention and repair strategies open.
BACKGROUND: Permanent aortic valve injury following percutaneous coronary intervention (PCI) is a rare but catastrophic complication that can cause acute severe aortic regurgitation (AR) and heart failure. CASE SUMMARY: A 49-year-old man developed recurrent acute pulmonary edema after a failed staged PCI for chronic total occlusion of the left anterior descending artery. Transthoracic echocardiography revealed severe eccentric AR caused by a 7-mm injury to the noncoronary cusp and left cusp confirming iatrogenic cusp laceration. He underwent successful surgical repair with pericardial patch reconstruction and coronary artery bypass grafting, with excellent recovery. DISCUSSION: Literature on catheter-induced aortic valve injury is sparse. This case highlights a rare cause of post-PCI shock where prompt echocardiography guided lifesaving surgical intervention. TAKE-HOME MESSAGES: Not all post-PCI cardiac decompensation is ischemic. Severe AR from iatrogenic aortic cusp injury, though rare, should be promptly excluded.
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Vijayachandra et al. (2026) conducted a case report in Iatrogenic aortic valve injury and acute severe aortic regurgitation following percutaneous coronary intervention (n=1). Surgical repair with pericardial patch reconstruction and coronary artery bypass grafting was evaluated on Clinical recovery following surgical repair of iatrogenic aortic valve injury. Surgical repair with pericardial patch reconstruction and CABG resulted in excellent recovery for a 49-year-old man with severe AR from a 7-mm iatrogenic aortic cusp injury post-PCI.
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