TAVI Patient with RCA Dissection, Post-TAVR High Degree AV Block and Acute Neurological Injury

Abstract

TAVI (Transcatheter Aortic Valve Implantation) is a minimally invasive procedure for the treatment of severe aortic stenosis (AS) in elderly and comorbid patients. Following the guidelines of eminent cardiac societies, a decision on the treatment modality is made by the so-called “heart team”. Despite being less invasive, the procedure is related to some complications, among which the most common ones are stroke, life-threatening bleeding, vascular injury, kidney injury, conduction disturbances demanding permanent pacemaker (PPM) implantation, and perivalvular leak (PVL). Here we present a case report of multiple periprocedural complications in the same patient, related to TAVI, such as right coronary artery (RCA) dissection on preoperative coronary angiography (CA), postprocedural acute neurologic injury and high grade atrioventricular (AV) block followed by PPM implantation.

Keywords

• TAVI
• Heart team
• Pacemaker implantation
• Paravalvular leak
• Coronary artery dissection
• High grade AV block