Self-Expandable Transcatheter Aortic Valve Frame Infolding: An Increasingly Recognized Complication.

Transcatheter aortic valve replacement (TAVR) with either a balloon-expandable or a self-expandable transcatheter heart valve (THV) is an approved therapy for patients with symptomatic severe aortic stenosis and high or intermediate surgical risk. Here we present a case of severe valve frame infolding of a CoreValve Evolut PRO® self-expandable THV (Medtronic Inc.), which was restored to optimal geometry with balloon post-dilation. LEARNING POINTS: Clinicians should be aware of the rare complication of frame infolding during deployment of a self-expanding transcatheter valve.Multimodality cardiac imaging is important to optimize transcatheter valve deployment.

Widowmaker Right Coronary Artery Treated With Drug-Eluting Stent Implantation.

We present a case of a single coronary artery system arising from the right sinus of Valsalva found to have an obstructive mid-vessel lesion with functional evidence of ischemia on stress testing. She was treated with a first-generation Cypher (Cordis, Johnson & Johnson, Hialeah, Florida) drug-eluting stent and remains asymptomatic at 14-year follow-up. (Level of Difficulty: Intermediate.).