Fatal coronary artery spasm triggered before transseptal puncture for mitral transcatheter edge-to-edge-repair: a case report


 
 
 Transient ST segment elevation or coronary artery spasm during transseptal catheterization have been previously described. Most cases were reversible or asymptomatic.
 
 
 
 We present a case of severe multiple coronary artery spasm with advanced atrioventricular block and ventricular fibrillation during compression of the fossa ovalis by sheath catheter, before the transseptal puncture procedure for mitral transcatheter edge-to-edge-repair.
 
 
 
 Mechanical effects of forward tension from transseptal puncture on the interatrial vagal network could be the most possible explanation of this phenomenon.
