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Anomalous left circumflex artery obstruction after transcatheter aortic valve-in-valve placement

Michael Corso1, Andrew W Bowman2

  • 1Cardiothoracic Imaging Fellow at Mayo Clinic Florida, Jacksonville, FL, USA. corso.michael@mayo.edu.

The International Journal of Cardiovascular Imaging
|May 26, 2026
PubMed

Insights

Coronary obstruction after TAVR valve-in-valve is a severe risk. Cardiac CT Angiography aids in identifying risk factors for this rare complication, with an incidence of 0.8% over the last decade.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Coronary obstruction (CO) is a rare but serious complication following transcatheter aortic valve replacement (TAVR) valve-in-valve (VIV) procedures.
  • Identifying patients at risk for CO is critical for procedural success and patient safety.

Purpose of the Study:

  • To summarize the incidence and risk factors of coronary obstruction after TAVR VIV.
  • To highlight the role of pre-procedural imaging in mitigating this complication.

Main Methods:

  • Review of literature and analysis of incidence data for CO post-TAVR VIV.
  • Emphasis on the diagnostic capabilities of Cardiac CT Angiography (CCTA) for pre-procedural risk assessment.

Main Results:

  • The incidence of CO after TAVR VIV has remained low at 0.8% over the past decade.
  • Pre-procedural planning using CCTA is essential for identifying anatomical risk factors that predispose to CO.

Conclusions:

  • While rare, CO remains a significant concern in TAVR VIV procedures.
  • Thorough pre-procedural assessment with CCTA is paramount to minimize the risk of coronary obstruction.

Keywords:
Anomalous coronary arteryCoronary obstructionValve-in-valve transcatheter aortic valve replacement

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