Usefulness of intravascular ultrasound to assess coronary occlusion after transcatheter aortic valve replacement

Transcatheter aortic valve replacement (TAVR) is now a proven treatment option for patients with severe aortic stenosis. Coronary ostia obstruction is a rare but a life-threatening complication of TAVR. In case of suspected coronary ostia obstruction, intravascular ultrasound study (IVUS) assessment could be feasible and useful to evaluate coronary ostia patency after the transcatheter aortic valve deployment, in high-risk scenarios for coronary occlusion. We described the case of a 73-year-old female with delayed coronary obstruction after TAVR with a 23-mm SAPIEN 3 ULTRA who underwent IVUS-guided percutaneous coronary intervention, using the chimney stenting technique, due to critical ostium left main impingement.