# Multimodality Imaging for Facilitating Percutaneous Coronary Intervention of a Calcified Nodule Post Redo TAVR

## TL;DR

This paper presents a case where advanced imaging techniques helped perform a successful heart procedure in a patient who had a previous heart valve replacement.

## Contribution

The paper highlights the use of MDCT and IVUS for successful PCI in a complex post-redo TAVR case.

## Key findings

- MDCT and IVUS were crucial for evaluating and planning PCI in a patient with calcified coronary lesions after redo TAVR.
- Successful PCI was achieved for severe calcified ostial stenosis with proper imaging guidance.
- Preprocedural imaging is essential for overcoming coronary access challenges in post-redo TAVR patients.

## Abstract

Transcatheter aortic valve replacement (TAVR) is vital for treating aortic stenosis, but coronary access after redo TAVR remains challenging. As TAVR is extended to younger patients, managing concurrent coronary artery disease will become crucial, with multidetector computed tomography (MDCT) playing a key role in coronary intervention planning.

An 83-year-old woman with multiple comorbidities and a history of redo TAVR and recent left main coronary artery stenting presented with NSTEMI. Imaging showed significant coronary involvement, prompting MDCT and intravascular ultrasound (IVUS) evaluation. Percutaneous coronary intervention (PCI) was performed, successfully treating severe calcified ostial stenosis.

This case demonstrates the value of MDCT and IVUS in managing complex coronary lesions after redo TAVR. It highlights the importance of preprocedural imaging to overcome coronary access challenges in patients with previous TAVR.

MDCT and IVUS are vital for planning PCI in post redo-TAVR patients. Coronary access is achievable with proper imaging guidance.