Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS) in patients with elevated surgical risk. Concomitant coronary artery disease affects 55-70% of patients with severe AS. Percutaneous coronary intervention in patients with TAVI can be challenging. We report a case of acute coronary obstruction immediately following transapical TAVI deployment requiring emergent rotational atherectomy.
Emergent Percutaneous Rotational Atherectomy to Bailout Surgical
Transapical Aortic Valve Implantation: A Successful Case of Heart Team
Turnaround
Choudhury,T, Bakar,SN, Kiaii,B, TeefyP. Emergent Percutaneous Rotational Atherectomy to Bailout Surgical
Transapical Aortic Valve Implantation: A Successful Case of Heart Team
Turnaround. Arq. Bras. Cardiol. 2019;113(6):1151-4.
Choudhury,,Tawfiq; Bakar,,Shahrukh N.; Kiaii,,Bob; Teefy,Patrick. Emergent Percutaneous Rotational Atherectomy to Bailout Surgical
Transapical Aortic Valve Implantation: A Successful Case of Heart Team
Turnaround. Arq. Bras. Cardiol., v. 113, n. 6, p. 1151-1154, Nov. 2019.
Choudhury,,T., Bakar,,S.N., Kiaii,,B., & Teefy,P. (2019). Emergent Percutaneous Rotational Atherectomy to Bailout Surgical
Transapical Aortic Valve Implantation: A Successful Case of Heart Team
Turnaround. Arq. Bras. Cardiol.,113(6), 1151-1154.
Choudhury,,Tawfiq and Bakar,,Shahrukh N. and Kiaii,,Bob and Teefy,Patrick. Emergent Percutaneous Rotational Atherectomy to Bailout Surgical
Transapical Aortic Valve Implantation: A Successful Case of Heart Team
Turnaround. Arq. Bras. Cardiol. [online]. 2019, vol. 113, n. 6, [cited 2025-10-23], pp.1151-1154. Available from: <https://abccardiol.org/en/article/emergent-percutaneous-rotational-atherectomy-to-bailout-surgical-transapical-aortic-valve-implantation-a-successful-case-of-heart-team-turnaround/>. ISSN 0066-782X.
Figure 1
Percutaneous coronary intervention to circumflex artery lesion. A)
Emergent coronary angiogram showing the new ostial left circumflex filling
defect and prior mid‑circumflex lesion. Inset view shows ostial left
circumflex lesion at greater magnification. B) Rotablator 1.5 mm burr
entering culprit ostial left circumflex artery lesion. C) Ostial left
circumflex lesion after rotational atherectomy shows angiographic
improvement. D) Final angiographic result after stent insertion and
high-pressure post-dilatation.