Transcatheter aortic valve replacement in a patient with an anomalous origin of the right coronary artery

We describe the first case of implantation of a transcatheter aortic valve implantation (TAVI) in a patient with an anomalous origin of the right coronary artery, coursing in between the aorta and pulmonary truncus to the right. After assessment of the risk of compression of the anomalous origin of the right coronary artery from the left coronary sinus (ARCA), the procedure was performed without complication. A brief discussion of the pathophysiology of ARCA is provided and the implications for TAVI as well as our recommendations are offered.