indigo-carmine and Aortic-Valve-Stenosis

An 81-year-old female with severe aortic valve stenosis underwent TAVR using the right femoral approach. Shortly after successful deployment of a 29 mm Evolut Pro valve (Medtronic), the patient became hypotensive and ST depressions were noted on telemetry. Selective left coronary angiography revealed coronary embolism to the left anterior descending/ first diagonal bifurcation. Mechanical aspiration was performed and a small piece of debris was retrieved. We believe it was a broken-off fragment of the femoral artery that migrated on the tip of the TAVR delivery system. This is the first reported case of such a complication.

Topics: Animals; Aortic Valve; Aortic Valve Stenosis; Catheters; Cats; Female; Heart Valve Prosthesis; Humans; Indigo Carmine; Prosthesis Design; Suction; Transcatheter Aortic Valve Replacement; Treatment Outcome