Transcatheter aortic valve implantation in the presence of an anomalous left circumflex coronary artery: a case report

This is a case of an anomalous left circumflex coronary artery (LCX) originating from the right coronary cusp with a retroaortic course in a patient with severe aortic valve stenosis requiring transcatheter aortic valve implantation (TAVI). In the context of TAVI, an anomalous LCX has been described only in a few case reports. In some, the LCX remains unaffected. However, occlusion after TAVI valve deployment has been described. We report pre-procedural imaging and procedural precautions prior to valve deployment in our case in which the LCX remained unaffected by the TAVR valve. More case reports or series are needed to help assess which characteristics are associated with an increased risk of anomalous LCX obstruction.