Extrinsic compression of the left main coronary artery by a contained aortic annular rupture following trans-catheter aortic valve implantation

•A unique case report of contained annular rupture after trans-apical TAVR using a balloon-expanding valve.•Rupture caused extrinsic compression of LMCA with hemodynamic collapse.•This was identified immediately and treated by stenting.•Patient' outcome was uneventful, and she is in good functional class at 6 months.

We present a case of an 83-year-old female who suffered from annular rupture with contained hematoma immediately after trans-apical implantation of balloon-expandable Sapien valve. The patient developed acute cardiogenic shock which resulted from an extrinsic compression of the left main coronary artery. We report the successful management of this complication.