Intramyocardial Calcification as a Rare but Significant Indication for Transfemoral TAVI?

We report on a 69-year-old female patient with severe valvular aortic stenosis who was hospitalized for cardiac decompensation for aortic valve replacement. Preoperative imaging (X-Ray, cat-scan and CMR) revealed significant and extraordinary intramyocardial calcification pronounced globally in the left ventricle and around the mitral valve. Due to high operative/surgical risk we preferred to approach an aortic valve replacement by transfemoral transcatheter procedure (TAVI-TF). Within the context of an undeniably elevated risk for ventricular injuries and dissections in conventional operations, highly progressed myocardial calcifications should lead to consider and prefer the transfemoral transcatheter aortic valve replacement procedure.