Abstract
IMAGE(S): CT imaging/autopsy findings were used for this study. CASE SUMMARY: An 87-year-old woman developed late coronary artery occlusion after transcatheter aortic valve replacement (TAVR) with chimney stenting. Coronary angiography failed to achieve selective cannulation of the left coronary artery, and wiring of the left coronary artery from a distance proved impossible. Autopsy findings revealed complete occlusion of the chimney stent from the jailed interface between the transcatheter heart valve and the aortic root. This case underscores the importance of recognizing an optimal anatomy for coronary protection and a potential risk of late coronary occlusion after TAVR-in-surgical aortic valve replacement with chimney stent.