NDLI: Rupture of the ascending aorta 6 months after TAVI procedure caused by TAVI prosthesis

Content Provider	Springer Nature : BioMed Central
Author	Hirnle, Grzegorz Kubik, Hanna Tenczyński, Dominik Kostro, Michał Hrapkowicz, Tomasz
Abstract	Background Transcatheter aortic valve implantation (TAVI) is indicated for elderly patients who often have severe comorbidities and high operative risk. Despite many advantages, it carries the potential for both early and late complications. The literature reports mainly periprocedural problems. This case report describes a rare instance of ascending aortic rupture as a late complication following TAVI. Case presentation An 81-year-old male with severe aortic stenosis (AS) was a non-surgical patient due to a high operative risk (EuroSCORE II 14.08%) and comorbidities, including cardiovascular problems, chronic obstructive pulmonary disease, myelodysplastic syndrome. During the TAVI procedure Medtronic CoreValve™ Evolut™ R-26 was implanted via the right femoral artery. Postoperative period elapsed without complications and the patient was discharged home. Six months later, the patient was re-admitted to the hospital on an emergency basis and transferred directly to the operating room due to ascending aortic rupture (EuroSCORE II 53.20%, GERAADA score 64.9%). Computed tomography angiography (CTA) showed aortic rupture with a multiple fresh blood reservoirs and thrombus around the ascending aorta originating from the spot where the nitinol frame of the TAVI valve was attached to the native aorta. Supracoronary excision of the ascending aorta with implantation of a vascular graft (Intergard Woven Graft 34 mm) was performed, preserving the earlier implanted TAVI valve. On the 9th day after surgery the patient’s general condition deteriorated, he suffered from circulatory and respiratory insufficiency. Furthermore, a gastrointestinal bleeding with the need for gastro-, and colonoscopy and multiple blood transfusions occurred. Patient developed urosepsis and acute renal failure with the need for hemodiafiltration. Despite intensive treatment, further deterioration of the medical condition of the patient. and finally the multiple organ failure was observed. Patient died on the 50th postoperative day. Conclusions TAVI is a safe method of treating severe AS, especially recommended for non-surgical candidates. Rupture of the ascending aorta is a rare but serious complication of TAVI that usually occur during or shortly after the procedure. This case report highlights the importance of post-procedural monitoring for such TAVI complications, even in the late period following TAVI, and if such complications occur, taking the risk to perform a life-saving operation.
Related Links	https://cardiothoracicsurgery.biomedcentral.com/counter/pdf/10.1186/s13019-024-02980-9.pdf
Ending Page	5
Page Count	5
Starting Page	1
File Format	HTM / HTML
ISSN	17498090
DOI	10.1186/s13019-024-02980-9
Journal	Journal of Cardiothoracic Surgery
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2024-08-28
Access Restriction	Open
Subject Keyword	Cardiac Surgery Thoracic Surgery Transcatheter aortic valve implantation Transcatheter aortic valve replacement Ascending aortic rupture Heart team Mitral leaflet aneurysm
Content Type	Text
Resource Type	Case study
Subject	Surgery Cardiology and Cardiovascular Medicine Pulmonary and Respiratory Medicine
Journal Impact Factor	1.5/2023
5-Year Journal Impact Factor	1.6/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Recurrent balloon rupture during Transcatheter Aortic Valve Replacement (TAVR) - a challenge to the Hybrid team

Ascending thoracic aorta aneurysm surgery and aortic valve repair during pregnancy.

Transapical aortic valve implantation in patients with pre-existing mitral valve prostheses: a case report

Transapical combined transcatheter aortic valve-in-valve implant and ascending aorta endovascular repair

Aortic valve stenosis after previous coronary bypass: Transcatheter valve implantation or aortic valve replacement?

Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation.

Severe mitral valve insufficiency caused by standard surgical aortic valve implantation and its reparation using suture-less prosthesis

Transcatheter aortic valve implantation: from fantasy to reality

A simple and reliable tool to quantify calcium burden of ascending aorta

Rupture of the ascending aorta 6 months after TAVI procedure caused by TAVI prosthesis

Similar Documents

Recurrent balloon rupture during Transcatheter Aortic Valve Replacement (TAVR) - a challenge to the Hybrid team

Ascending thoracic aorta aneurysm surgery and aortic valve repair during pregnancy.

Transapical aortic valve implantation in patients with pre-existing mitral valve prostheses: a case report

Transapical combined transcatheter aortic valve-in-valve implant and ascending aorta endovascular repair

Aortic valve stenosis after previous coronary bypass: Transcatheter valve implantation or aortic valve replacement?

Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation.

Severe mitral valve insufficiency caused by standard surgical aortic valve implantation and its reparation using suture-less prosthesis

Transcatheter aortic valve implantation: from fantasy to reality

A simple and reliable tool to quantify calcium burden of ascending aorta

Rupture of the ascending aorta 6 months after TAVI procedure caused by TAVI prosthesis