CTICasesDemand Ischemia and LVOT Obstruction Post-TAVR
Imaging findings
Frontal chest radiograph and post-TAVR CT demonstrate a migrated CoreValve prosthesis telescoped inside a second, larger CoreValve. The migrated valve is severely narrowed and extends high into the ascending aorta. Contrast-enhanced CT reveals striking, diffuse subendocardial hypoenhancement involving all myocardial walls and the papillary muscles.
Key takeaways
Dislodgement or migration of a TAVR prosthesis into the ascending aorta is a rare but catastrophic iatrogenic event. If the valve fails to expand fully or causes severe left ventricular outflow tract obstruction, it can drastically reduce coronary perfusion, leading to profound, multi-territory subendocardial ischemia, cardiogenic shock, and highly elevated troponin levels.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Novel Endotracheal Tube Design with Distal GapArtifact
- Endobronchial Mycobacterium avium Complex (MAC) InfectionInfection
- Bronchial Migration of a Tumor Fiducial MarkerIatrogenic
- Retained Surgical Sponge (Gossypiboma) in the MediastinumIatrogenic
- Aortic Valve Papillary FibroelastomaNeoplastic
- NUT Carcinoma of the LungNeoplastic
- Post-Radiation Accelerated Atherosclerosis and Radiation OsteitisInflammatory
- Transcostal Lung Herniation with Localized Parenchymal FibrosisOther
See all cases from August 6, 2017 →
Related Iatrogenic cases
- Lucite Sphere Plombage Therapy for Tuberculosis
- Iatrogenic Esophageal Perforation and Mediastinal Hematoma secondary to Enteric Tube Malposition
- Coronary Sinus Pacemaker Lead Migration
- Iatrogenic Chylothorax and Extrapleural Chyloma after First Rib Resection
- Incarcerated Iatrogenic Diaphragmatic Hernia after Hepatectomy
- Right Atrial Pacemaker Lead Perforation