ArticleJACC. Case reports2025
Coronary Occlusion During Transcatheter Aortic Valve Replacement Due to Prolapsing Aortic Valve Papillary Fibroelastoma.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundTranscatheter aortic valve replacement (TAVR) is rarely attempted in cases of aortic stenosis with concomitant papillary fibroelastoma because of concerns for intraprocedural systemic embolization. Coronary obstruction caused by prolapse of the mass into the coronary ostia has not yet been reported, to our knowledge. CASE SUMMARY: An 85-year-old woman with severe symptomatic aortic stenosis and high surgical risk was referred for TAVR. The result of preoperative imaging was notable for an 8-mm left coronary cusp papillary fibroelastoma. When a transcatheter heart valve was deployed, the mass prolapsed into and obstructed the left coronary artery. Emergent left main coronary artery stenting restored coronary flow. DISCUSSION: Whereas embolization is an important concern, coronary obstruction due to leaflet mass prolapse can occur. Careful preprocedural planning and up-front coronary protection may mitigate this risk. TAKE-HOME MESSAGE: TAVR in patients with aortic valve papillary fibroelastoma carries theoretical risks of both distal embolization and coronary obstruction.
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