The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Coronary interventions

A suspicious calcium spike

EuroIntervention 2015;11:e1 published online e-article August 2015. DOI: 10.4244/EIJV11I4A94

1. Cardiology Department, Hospital Clínico Universitario de Valencia, INCLIVA, Universitat de València, Valencia, Spain; 2. Department of Interventional Cardiology, Policlínica Gipuzkoa, San Sebastián, Spain
An 82-year-old female with severe aortic stenosis was referred for transcatheter aortic valve replacement (TAVR). CT showed heavy calcification, especially in the junction of right coronary and non-coronary leaflets (Figure 1A), but no calcium in the outflow tract. Haemodynamic impairment occurred immediately after 26 mm Edwards SAPIEN XT® (Edwards Lifesciences, Irvine, CA, USA) prosthesis deployment (Moving image 1). Aortography showed contrast leak through the aortic annulus (Figure 1B, Moving image 2). The patient underwent urgent surgery, where bleeding partially contained by the epicardial fat and aortic wall haematoma were observed (Figure 1C). Aortic annulus rupture was located between the right coronary sinus and ...

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