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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Published on: May 21, 2017

Left main occlusion secondary to aortic root rupture following transcatheter aortic valve replacement managed by left

Rebeca J Kim1, Elizabeth McGehee, Michael J Mack

  • 1Cardiopulmonary Research Science and Technology Institute (CRSTI), Dallas, Texas.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 15, 2013
PubMed

Insights

A rare complication during transcatheter heart valve replacement is reported: acute left main coronary artery occlusion. This life-threatening event resulted from a periaortic root hematoma caused by annular rupture.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
  • Complications, though rare, can occur during TAVR, necessitating prompt recognition and management.
  • Understanding potential adverse events is crucial for procedural safety.

Observation:

  • A case of acute left main coronary artery occlusion is presented.
  • The occlusion was secondary to a periaortic root hematoma.
  • The hematoma resulted from annular rupture during TAVR.

Findings:

  • Annular rupture during TAVR can lead to significant periaortic hematoma formation.
  • Periaortic hematoma can cause mechanical compression or displacement of coronary arteries.
  • This mechanical effect can result in acute coronary artery occlusion, specifically affecting the left main coronary artery.

Implications:

  • This case highlights a rare but critical complication of TAVR.
  • Early diagnosis and intervention are vital for patients experiencing coronary occlusion post-TAVR.
  • Procedural techniques and imaging may need refinement to minimize the risk of annular rupture and subsequent complications.

Keywords:
TAVRcomplicationgraft protectionleft main occlusion

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