{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T19:10:46Z","timestamp":1778872246045,"version":"3.51.4"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute transcatheter heart valve (THV) dysfunction immediately after transcatheter aortic valve implantation (TAVI) is uncommon but can be catastrophic. Mechanical obstruction by migrated vascular tissue is exceptionally rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>An 80-year-old woman with symptomatic very severe aortic stenosis and high surgical risk underwent transfemoral TAVI with a 23-mm self-expanding Evolut FX valve (Medtronic, Minneapolis, MN, USA). Preprocedural computed tomography showed severe circumferential calcification of the left common iliac artery (CIA) with a preserved lumen (6.8 \u00d7 4.9\u2005mm) and a small aortic annulus (area, 244.9\u2005mm2; perimeter, 55.9\u2005mm). After valve deployment, invasive haemodynamics showed no reduction in the transvalvular pressure gradient (mean\/peak, 58\/97\u2005mmHg before vs. 63\/98\u2005mmHg after deployment). Transoesophageal echocardiography demonstrated a tubular structure restricting leaflet opening. Balloon post-dilatation resulted in transient echocardiographic improvement but was complicated by balloon rupture, and a mobile intravalvular structure persisted. Emergency surgical conversion was performed. Intraoperatively, a calcified tubular structure with a lumen-like appearance was found on the guidewire and was impinging on the THV leaflets. The THV was explanted, and surgical aortic valve replacement was performed. Histology confirmed calcified vascular intimal tissue, consistent with detachment from the left CIA. The postoperative course was uneventful, and the patient was discharged home.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In severely calcified iliofemoral access, endarterectomy-like intimal detachment can occur during device passage and, rarely, can migrate into a self-expanding THV, causing acute leaflet opening restriction. Early recognition using multimodality imaging and timely surgical bailout may be life-saving.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag314","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:08:19Z","timestamp":1777637299000},"source":"Crossref","is-referenced-by-count":0,"title":["Acute leaflet opening restriction caused by endarterectomy-like iliac artery intimal detachment entrapped within a self-expanding transcatheter aortic valve: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0753-4394","authenticated-orcid":false,"given":"Akihiko","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Fukushima Medical University , 1 Hikarigaoka, Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuuki","family":"Muto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Fukushima Medical University , 1 Hikarigaoka, Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Fukushima Medical University , 1 Hikarigaoka, Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Fukushima Medical University , 1 Hikarigaoka, Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuchika","family":"Takeishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Fukushima Medical University , 1 Hikarigaoka, Fukushima 960-1295 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026051514300506900_ytag314-B1","doi-asserted-by":"crossref","first-page":"4635","DOI":"10.1093\/eurheartj\/ehaf194","article-title":"2025 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"46","author":"Praz","year":"2025","journal-title":"Eur Heart J"},{"key":"2026051514300506900_ytag314-B2","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1016\/j.jacc.2021.02.038","article-title":"Valve academic research consortium 3: updated endpoint definitions for aortic valve clinical research","volume":"77","author":"VARC-3 WRITING COMMITTEE","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026051514300506900_ytag314-B3","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.119.008227","article-title":"Incidence, temporal trends, and associated outcomes of vascular and bleeding complications in patients undergoing transfemoral transcatheter aortic valve replacement: insights from the Society of Thoracic Surgeons\/American College of Cardiology Transcatheter Valve Therapies Registry","volume":"13","author":"Sherwood","year":"2020","journal-title":"Circ Cardiovasc Interv"},{"key":"2026051514300506900_ytag314-B4","doi-asserted-by":"crossref","first-page":"e176","DOI":"10.4244\/EIJ-D-22-01030","article-title":"Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves","volume":"19","author":"Wienemann","year":"2023","journal-title":"EuroIntervention"},{"key":"2026051514300506900_ytag314-B5","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.echo.2017.10.022","article-title":"Echocardiographic imaging for transcatheter aortic valve replacement","volume":"31","author":"Hahn","year":"2018","journal-title":"J Am Soc Echocardiogr"},{"key":"2026051514300506900_ytag314-B6","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13019-023-02131-6","article-title":"Detrimental consequences after intimal disruption of subclavian artery during transcathether aortic valve implantation","volume":"18","author":"Reuthebuch","year":"2023","journal-title":"J Cardiothorac Surg"},{"key":"2026051514300506900_ytag314-B7","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.119.013801","article-title":"Impact of complications during transfemoral transcatheter aortic valve replacement: how can they be avoided and managed?","volume":"8","author":"Scarsini","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2026051514300506900_ytag314-B8","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1016\/j.jcin.2024.07.009","article-title":"Impact of severity and extent of iliofemoral atherosclerosis on clinical outcomes in patients undergoing TAVR","volume":"17","author":"Nakase","year":"2024","journal-title":"JACC Cardiovasc Interv"}],"container-title":["European Heart Journal - 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