TY - JOUR T1 - Ischaemic changes during transcatheter aortic valve implantation JF - Heart JO - Heart SP - 801 LP - 866 DO - 10.1136/heartjnl-2019-316020 VL - 106 IS - 11 AU - Mohammad Alkhalil AU - Mark. S Spence AU - Colum Owens Y1 - 2020/06/01 UR - http://heart.bmj.com/content/106/11/801.abstract N2 - A 59-year-old woman with trisomy 21 underwent heart team discussion for symptomatic severe aortic stenosis. Investigations revealed a type I bicuspid aortic valve with minor calcification, normal coronary arteries, preserved left ventricular function and small aorta but adequate coronary height. Heart team decision, factoring patient and family preference, was for transcatheter aortic valve implantation (TAVI).A 26 mm self-expanding valve (Evolute R, Medtronic) was directly implanted but embolised, leading to mechanical obstruction of the left coronary artery. The valve was subsequently repositioned into the ascending aorta using snares and importantly … ER -