Aortic valve injury and complete atrioventricular block related to Impella device.

The Impella device can effectively unload the left ventricle in patients undergoing high-risk percutaneous coronary intervention (PCI) and in cases of cardiogenic shock. Herein, we report a rare case of a 59-year-old man who was treated using PCI and the Impella CP for acute coronary syndrome. The patient suffered from severe acute aortic regurgitation and complete atrioventricular block (CAVB) with hemodynamic instability soon after the Impella removal. The non-coronary cusp (NCC) tear occurred from the NCC and right coronary cusp commissure to the middle of the NCC. The patient successfully underwent aortic valve replacement with no CAVB postoperatively.