Descending Aorta Rupture after Transcatheter Aortic Valve Embolization

Ann Vasc Surg. 2018 May:49:312.e1-312.e4. doi: 10.1016/j.avsg.2017.11.042. Epub 2018 Feb 15.

Abstract

Background: To report a case of rupture of the descending aorta after aortic migration during transcatheter aortic valve replacement (TAVR).

Methods: An 85-year-old man with a severe and symptomatic aortic stenosis underwent elective TAVR, which complicated with embolization into the ascending aorta. While repositioning into the descending aorta, the procedure complicated with aortic rupture.

Results: The patient required urgent thoracic intravalve stent-graft implantation (thoracic endovascular aortic repair [TEVAR]). Reintervention with other stent graft was required 2 days after initial procedure as proximal rupture was again diagnosed. Patient was discharged 50 days later because of other medical complications. He remains stable at 1 year of follow-up.

Conclusions: TEVAR is a valid and safe option in the treatment of iatrogenic acute aortic rupture due to TAVR.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aorta, Thoracic* / diagnostic imaging
  • Aorta, Thoracic* / surgery
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / etiology*
  • Aortic Rupture / surgery
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation
  • Computed Tomography Angiography
  • Echocardiography, Transesophageal
  • Embolism / diagnostic imaging
  • Embolism / etiology*
  • Endovascular Procedures
  • Foreign-Body Migration / diagnostic imaging
  • Foreign-Body Migration / etiology*
  • Heart Valve Prosthesis / adverse effects*
  • Humans
  • Male
  • Severity of Illness Index
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Transcatheter Aortic Valve Replacement / instrumentation
  • Treatment Outcome