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Successful Mechanical Aspiration of Embolized Vessel Fragment During TAVR With Penumbra Indigo Cat Rx Catheter.

An 81-year-old female with severe aortic valve stenosis underwent TAVR using the right femoral approach. Shortly after successful deployment of a 29 mm Evolut Pro valve (Medtronic), the patient became hypotensive and ST depressions were noted on telemetry. Selective left coronary angiography revealed coronary embolism to the left anterior descending/ first diagonal bifurcation. Mechanical aspiration was performed and a small piece of debris was retrieved. We believe it was a broken-off fragment of the femoral artery that migrated on the tip of the TAVR delivery system. This is the first reported case of such a complication.