# ST-Segment Elevation Myocardial Infarction Caused by Embolized Transcatheter Aortic Valve in Ascending Aorta

## TL;DR

Embolized transcatheter aortic valves can block blood flow, causing heart attacks, but this can be diagnosed and treated with simple techniques.

## Contribution

Demonstrates a novel mechanism of ischemia caused by embolized valves and provides a practical treatment approach.

## Key findings

- Embolized valves obstruct diastolic retrograde blood flow, leading to myocardial ischemia.
- Aortic stent implantation can restore backflow and resolve ischemia.
- Aortography and wire-guided leaflet opening can diagnose the issue effectively.

## Abstract

Embolized valves during transcatheter aortic valve replacement can cause myocardial ischemia by obstructing diastolic retrograde blood flow.

To prove the described mechanism of ischemia, we performed aortography with catheter above the embolized valve and placed a stiff wire through the embolized valve, causing leaflet opening while monitoring electrocardiogram. As a treatment method, an aortic stent was implanted from the embolized valve into the aortic arch, enabling backflow and resolving the ischemia.

Overlooking the described cause of ischemia is the biggest pitfall because it can be diagnosed and treated using simple techniques.

Embolized transcatheter aortic valve replacement valve can cause myocardial ischemia by blocking the diastolic backflow of blood. Aortography and opening of the embolized valve leaflets with wire can be used for diagnosis, and aortic stent implantation in the embolized valve can be used as a treatment modality.