{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:30Z","timestamp":1753876230164,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Delayed coronary obstruction (DCO) is a rare but potentially life-threatening complication after transcatheter aortic valve implantation (TAVI) mostly affecting the left main coronary artery (LMCA) and often caused by prosthesis endothelialization or thrombus formations. Herein, we report an unusual case of a delayed LMCA-obstruction caused by a calcium nodule, which was diagnosed 4 months after TAVI due to recurrent ventricular tachycardia (VT) episodes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 73-year-old patient was readmitted to an external hospital with syncope three months after TAVI. Fast VT could be induced in electrophysiological examination, why the patient received a two-chamber implantable cardioverter defibrillator (ICD). However, after 1 month the patient was readmitted to our department with another syncope. Implantable cardioverter defibrillator records revealed multiple fast VT episodes (200\u2013220 b.p.m.). In addition, the patient reported new-onset exertional dyspnoea (New York Class Association Stage III) and elevated high-sensitive cardiac troponin of 115 ng\/L. Due to the symptoms and laboratory markers indicating potential myocardial ischaemia, a cardiac computed tomography angiography (CCTA) was performed. Cardiac computed tomography angiography revealed obstruction of the LMCA likely caused by calcium shift during TAVI. After CCTA-guided percutaneous coronary intervention, patient\u2019s course remained uneventful.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The present case report highlights the role of CCTA as a powerful non-invasive diagnostic tool in complex settings after TAVI. Delayed coronary obstruction as a procedural complication can occur after TAVI and manifest with various symptoms, including new-onset or recurrent VTs, like in the present case. Cardiac computed tomography angiography provided accurate assessment of the implanted prosthesis and detection of DCO, thus guiding the subsequent PCI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae300","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T07:17:33Z","timestamp":1718176653000},"source":"Crossref","is-referenced-by-count":0,"title":["Syncope due to recurrent ventricular tachycardias after transcatheter aortic valve implantation with unexpected diagnosis in cardiac computed tomography: a case report"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7390-5287","authenticated-orcid":false,"given":"Philipp","family":"Breitbart","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg , S\u00fcdring 15, 79189 Bad Krozingen , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Billig","sequence":"additional","affiliation":[{"name":"Medical Department II, University Hospital Bonn , Bonn , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital , Heidelberg , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research) , Partner site Heidelberg , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Pneumology, Heidelberg University Hospital , Heidelberg , Germany"},{"name":"DZHK (German Centre for Cardiovascular Research) , Partner site Heidelberg , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6038-2253","authenticated-orcid":false,"given":"Grigorios","family":"Korosoglou","sequence":"additional","affiliation":[{"name":"GRN Hospital Weinheim, Department of Cardiology, Vascular Medicine & Pneumology , Weinheim , Germany"},{"name":"Weinheim Cardiac Imaging Center, Hector Foundation , Weinheim , Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"2024062810223691800_ytae300-B1","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.jacc.2018.01.066","article-title":"Delayed coronary obstruction after transcatheter aortic valve replacement","volume":"71","author":"Jabbour","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2024062810223691800_ytae300-B2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 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