CTICasesRCA Stent Protrusion into the Aortic Root Lumen (Pre-TAVI Planning CT)
Imaging findings
Pre-TAVI planning CT shows a calcified, thickened aortic valve with expected findings of aortic stenosis. A right coronary artery stent is identified, and a portion of this stent is seen protruding into the lumen of the aortic root at the level where a transcatheter aortic valve would be seated. The stent protrusion is sufficient that it would potentially be at risk of being compressed or damaged by transcatheter valve deployment.
Key takeaways
Pre-TAVI CT planning must include careful evaluation of the aortic root for any coronary stents that may protrude into the lumen, as this can complicate valve deployment. A coronary artery stent that protrudes significantly into the aortic root may need to be addressed before proceeding with TAVI, potentially by trimming or other intervention. This represents an uncommon but critical pre-procedural finding.
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