Large calcific mass embolization during transfemoral aortic valve implantation

摘要

In a 82-year-old female a 22-mm stented Soprano (Sorin Biomedica Cardio, Saluggia, Italy), bioprosthesis dysfunction was documented. Computed tomography angiography (CTA) showed diffuse aortic calcifications and the presence of an aberrant right subclavian artery or arteria lusoria (AL) (Fig. 1A–D). A valve-in-valve transcatheter aortic valve implantation (TAVI) with a 26-mm Corevalve Evolut R (Medtronic, Minneapolis, MN, USA) was performed via transfemoral access. Due to blood loss, CTA was required; aside a retroperitoneal hematoma, a large calcified plaque, previously undetected at the thoraco-abdominal passage was unexpectedly detected (Fig. 1E, F), causing a 50% caliber reduction.