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Periaortic hematoma after transcatheter aortic valve replacement: description of a new complication

Philippe Généreux1, George R Reiss, Susheel K Kodali

  • 1Columbia University Medical Center/New York Presbyterian Hospital and the Cardiovascular Research Foundation, New York, NY 10032, USA. pg2295@columbia.edu

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|August 2, 2011
PubMed

Insights

This case series highlights periaortic hematomas after transcatheter aortic valve replacement (TAVR). Key patient and procedural factors, including bulky calcification and device mismatch, may contribute to this rare complication.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Complications, though infrequent, require careful monitoring and management.
  • Periaortic hematomas are a rare but serious post-TAVR complication.

Purpose of the Study:

  • To describe a case series of three patients experiencing periaortic hematomas post-TAVR.
  • To identify potential risk factors and clinical characteristics associated with this complication.
  • To emphasize the role of intraprocedural imaging in early detection and management.

Main Methods:

  • Retrospective review of three TAVR cases with periaortic hematomas.
  • Analysis of patient demographics, procedural details, and echocardiographic findings.
  • Intraprocedural transesophageal echocardiogram (TEE) utilized for all cases.

Main Results:

  • All patients were elderly females with low body weight.
  • Common findings included bulky noncoronary cusp calcification, annular-device size mismatch, and severe post-TAVR hypertension.
  • Early TEE detection facilitated prompt therapeutic intervention.

Conclusions:

  • Advanced age, female gender, bulky calcification, device mismatch, and hypertension are potential contributors to periaortic hematomas post-TAVR.
  • Intraprocedural TEE is crucial for early recognition of this rare complication.
  • Timely diagnosis and management lead to favorable outcomes.

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