Complete Crush of a Balloon-expandable Bioprosthesis After Prolonged Cardiopulmonary Resuscitation

We report on a case of an 88-year-old woman with severe aortic stenosis. Concomitant morbidities consisted of severe atherosclerosis, a large thoracoabdominal aortic aneurysm, atrial fibrillation, malignancy of the rectum with termino-terminal descendorectostomy, chronic renal insufficiency, and adipositas (body mass index, 31.1). Due to the high surgical risk (EuroSCORE II, 12.3%), the patient was considered to be a good candidate for transcatheter aortic valve implantation (TAVI). In an interdisciplinary approach the patient underwent transapical TAVI (Edwards Sapien XT, 26 mm) due to anatomic reasons (horizontal aorta) in addition to a large thoracoabdominal aneurysm that was mostly covered by thrombus formation (Figure A, B). Due to the relevant comorbidities, we decided to embed the TAVI as part of a staged procedure treatment strategy. The procedure went exceptionally well with a wire position that was kept at all times out of the thoracic aneurysm and was followed by a benign postinterventional course. As a sign of …