title: [Occlusion of the left main stem after transcatheter aortic valve implantation (TAVI)--a rare complication].
abstract: METHODS
  In an 85-year-old woman with severe symptomatic aortic stenosis transcatheter aortic valve implantation (TAVI) was performed via a transfemoral access. A 26 mm Sapien Edwards XTTM prosthesis was implanted.
  
  
  RESULTS
  Shortly after the implantation arterial blood pressure began to drop. Aortic root angiography demonstrated occlusion of the left main stem and the small right coronary artery.
  
  
  METHODS
  Mechanical resuscitation had to be started, while a 6 French guiding catheter was inserted. A guide wire could be inserted into the left main stem, which resulted in slow antegrade flow (TIMI grade II), with an almost immediate rise in the arterial pressure. Implantation of a bare metal stent into the ostium of the left main stem resulted in a normal flow to the left coronary artery and arterial blood pressure returned to normal.
  
  
  RESULTS
  Further clinical course was uneventful and the patient could be discharged one week later. Sixteen months after the procedure, she is still well.
  
  
  CONCLUSIONS
  TAVI should be performed by experienced staff with a cardiac surgery unit in stand-by; the compartment should be equipped with all facilities of an interventional catheterization laboratory.
authors.affiliation: Herzzentrum Ludwigshafen, Kardiologie.
authors.forename: R
authors.initials: R
authors.lastname: Zahn
authors.forename: T
authors.initials: T
authors.lastname: Bauer
authors.forename: R
authors.initials: R
authors.lastname: Schiele
mesh_terms: D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D015607:Stents