Transcatheter aortic valve implantation (TAVI) has become a common procedure for treatment of aortic valve stenosis, especially in patients with an increased risk for major adverse cardiac events during conventional aortic valve implantation using thoracotomy. While TAVI has been shown to reduce the periprocedural life-threatening risks, there are still several complications that can occur.

This case is particularly interesting as the patient did not report any cardiac symptoms and complained rather about pain in the contralateral right groin. Therefore, postinterventional ultrasound studies of the heart can sometimes be helpful to detect silent postprocedural complications.

When using the transfemoral approach, vascular injuries are the major risk with reported rates of 11.7% for dissection, occlusion and perforation. Preoperative CT of the major vessels improves planning of the procedure and can reduce the perioperative complication rates and is therefore routinely performed atour institution. However, the learning curve is steep and major adverse events can occur, especially since this technique is usually performed on a high-risk patient cohort.