Delayed subtotal coronary obstruction after transapical aortic valve implantation.

We report on an obstruction of the left main coronary artery which occurred after completion of an uneventful transapical aortic valve implantation (TAVI) procedure. This delayed subtotal coronary obstruction was detected by routine final transesophageal echocardiographic examination. Emergency implantation of a coronary stent eliminated myocardial ischemia. This case demonstrated that coronary artery obstruction can occur not only during the TAVI procedure but also some time later. This finding reinforces the idea that these patients must also be carefully evaluated in the early post-procedure period.