Challenging coronary access in a patient with delayed coronary obstruction following TAVR, facilitated by the use of a dual lumen microcatheter

Abstract

Late onset coronary occlusion post-transcatheter aortic valve replacement (TAVR) is a rare yet significant complication. We present an 85-year-old female with chest pain secondary to left main coronary artery obstruction eleven months post-TAVR. Angiography revealed a partial occlusion necessitating percutaneous coronary intervention. Despite initial challenges in engagement due to interaction with the TAVR valve, use of a dual lumen microcatheter facilitated successful stenting, resulting in resolution of the obstruction. This case underscores the diagnostic and therapeutic complexities of late coronary occlusion after TAVR, emphasizing the importance of vigilant recognition and innovative interventional strategies in optimizing patient outcomes.