Acute aortic regurgitation due to aortic valve leaflet injury during percutaneous coronary intervention: a case report.

Acute aortic regurgitation is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). We report the case of a patient admitted with ST-segment elevation myocardial infarction who underwent primary PCI with rotational atherectomy due to heavily calcified coronary lesions. The procedure was initially successful; however, shortly after the intervention, the patient experienced sudden clinical deterioration with acute heart failure. Transthoracic and transesophageal echocardiography revealed an iatrogenic injury to the aortic valve leaflet, resulting in severe acute aortic regurgitation that contributed to the rapid hemodynamic deterioration. This case highlights a very rare but serious complication of PCI with rotational atherectomy. Aortic valve leaflet injury leading to acute aortic regurgitation should be considered in patients who develop sudden hemodynamic instability after complex coronary interventions. Early recognition with prompt echocardiographic assessment is crucial for appropriate management and may be life-saving.