Unusual coronary occlusion post transcatheter aortic implantation: the importance of clinical assessment.

Despite the increasing experience with transcatheter aortic valve implantation, the incidence of severe complications is still relevant. One of the most feared complications is coronary obstruction. This life-threatening complication, occurring in up to 1% of patients, might be catastrophic, presenting with hemodynamic instability but allowing for rapid detection and treatment. To date, all published cases have reported ostial occlusions of either the left main or the right coronary artery. We describe an uncommon presentation of distal right coronary artery obstruction post transcatheter aortic valve implantation that was diagnosed after the patient developed chest pain in the recovery room.