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You are here: Contents > 2015 > Volume 24 Number 4 July 2015 > AORTIC VALVE DISEASE > Aortic Annulus Rupture During TAVI: A Therapeutic Dilemma in the Inoperable Patient

Aortic Annulus Rupture During TAVI: A Therapeutic Dilemma in the Inoperable Patient

Nick Hiltrop1, Tom Adriaenssens1,4, Steven Dymarkowski3, Paul Herijgers2,4, Christophe Dubois1,4

Departments of 1Cardiovascular Medicine, 2Cardiac Surgery and 3Radiology, University Hospitals Leuven, Leuven, 4Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

Aortic annulus rupture is a rare complication of transcatheter aortic valve implantation (TAVI), related to relative valve oversizing or eccentric calcification. A case is reported of periprocedural cardiac tamponade caused by aortic annulus rupture. Optimal management of periprocedural aortic annulus rupture and pseudoaneurysm formation in patients considered too frail for surgery should be discussed in a multidisciplinary setting.

Video 1: Aortic angiography after transcatheter aortic heart valve implantation showing contrast extravasation at the annular level.

Video 2: Aortic angiography after insertion of a pericardial drain and neutralization of heparin, showing no further contrast extravasation at the annular level. A mild paravalvular regurgitation can be seen.

Video 3: At two months’ follow up, a shunt is seen between the aortic annulus and the right ventricle on 2D color transthoracic echocardiography (color zoom box of the aortic root in apical four-chamber view).

Video 4: At two months’ follow up, a shunt is seen between the aortic annulus and the right ventricle on 2D-color transthoracic echocardiography (parasternal long-axis view).

The Journal of Heart Valve Disease 2015;24:436-438


Aortic Annulus Rupture During TAVI: A Therapeutic Dilemma in the Inoperable Patient

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