Ventricular Septal Defect and Complete Atrioventricular Block Following Transcatheter Aortic Valve Implantation: A Case Report

Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement for severe aortic stenosis (AS) in high-risk patients, yet rare, potentially life-threatening complications still occur.We describe a 75-year-old man with severe symptomatic AS who underwent TAVI using a balloon-expandable Myval prosthesis; the procedure was complicated by complete atrioventricular block requiring permanent pacemaker implantation.At 1-month follow-up, he presented with dyspnea.Transthoracic echocardiography demonstrated a newly developed perimembranous ventricular septal defect (VSD) adjacent to the prosthetic valve, resulting in a significant left-to-right shunt.This case underscores the need for meticulous pre-procedural assessment of the distribution of calcification, careful procedural planning and technique, and post-procedural vigilance for both conduction disturbances and rare structural complications, such as VSD, following TAVI.