•  
  •  
 

Abstract

Transcatheter aortic valve replacement (TAVR) has become a well-established treatment option for patients with severe aortic stenosis. With advances in the field and positive outcomes in clinical trials, TAVR use has expanded from being limited to older patients with prohibitive surgical risk to younger patients with intermediate and low surgical risk. As operators’ experiences have grown and technology has evolved, there are fewer TAVR complications. However, when complications do occur, they remain associated with significant morbidity and mortality. Aortic annulus rupture is a catastrophic complication of TAVR. Risk factors for annulus rupture include valve oversizing, female gender, a large calcification burden in the subannular area and left ventricular outflow tract, a small annulus, a calcified bicuspid aortic valve, and a narrow aortic root. When a rupture occurs, emergent cardiac surgery is a common intervention; however, not all patients are candidates for emergent surgery. We present a case of a 79-year-old female patient who developed an annular rupture during TAVR with a balloon-expandable valve. The patient was successfully treated; we reversed anticoagulation and controlled her blood pressure. We also performed a pericardiocentesis and provided temporary support by using extracorporeal membrane oxygenation.

Download

Share

COinS