Case 113: Manual of CTO Interventions: CTO PCI in prior TAVR patient

A patient with two prior TAVRs (two CoreValve Evolut valves) was referred for attempting PCI of RCA CTO in hope that it could improve his severe mitral regurgitation. Engagement of the coronary ostia was very challenging due to the two CoreValves. We were able to engage the left main but could not engage the RCA. Retrograde crossing attempts were unsuccessful and the procedure was eventually stopped after reaching the contrast limit. Prior TAVR can hinder subsequent PCI attempts.