Successful percutaneous management of left main trunk occlusion during percutaneous aortic valve replacement.

Transcatheter aortic valve replacement with balloon-expandable and self-expandable stent valves is available in Europe. The balloon-expandable valve is currently being investigated in a randomized trial in the US. We report an uncommon complication of left main trunk occlusion with balloon-expandable valve deployment and its successful percutaneous management. Left main trunk occlusion was immediately recognized when patient did not recover blood pressure after valve deployment. TandemHeart support was used to stabilize the patient immediately and left main trunk was successfully stented. Analysis of anatomy leading to this complication and potential measures to predict and prevent such a complication are discussed in this report. (c) 2009 Wiley-Liss, Inc.