Left ventricular outflow tract rupture during transcatheter aortic valve implantation: anatomic evidence of the vulnerable area

- The case reported, together with a review of the literature of all published cases, illustrates the value of clinic-pathologic correlation to assess the anatomic basis of complication during interventional procedures.
- It demonstrates that bulky calcification in the left ventricular outflow tract under the left-coronary aortic cusp could be a risk factor for rupture during TAVI.
- At this level the LVOT is a thin-wall structure in direct contact with the prosthesis and acts as locus minoris resistentiae when the calcified nodules are mechanically compressed and displaced by the fully expanded prosthesis.