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An 89-year-old woman underwent transcatheter aortic valve implantation (TAVI) using a transapical approach for severe senile calcific aortic stenosis (area = 0.39 cm2; peak and mean gradients = 176 mm Hg and 103 mm Hg, respectively; ejection fraction = 62%). Preprocedural computed tomography imaging revealed severe calcification of the left coronary cusp and a small sinus of Valsalva (Figure 1A). The patient was considered high-risk for coronary obstruction after TAVI.Figure 1. Computed tomography (CT) imaging before and after transcatheter aortic valve implantation (TAVI). A , CT imaging before TAVI showing a severe calcification of the left coronary cusp and a small sinus of valsalva. B , CT imaging after TAVI showing the displaced leaflet calcification and …

circulation

Intravascular Ultrasound Observation of an Obstruction of the Left Main Coronary Artery Caused by Displaced Leaflet Calcification and Hematoma After Transcatheter Aortic Valve Implantation