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Updated: Apr 7, 2026
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
712
Factor VIIa for Annulus Rupture After Transcatheter Aortic Valve Replacement
Jeffrey E Keenan1, John P Vavalle2, Asvin M Ganapathi1
1Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
The Annals of Thoracic Surgery
|July 5, 2015
Summary
Transcatheter aortic valve replacement (TAVR) can be complicated by aortic annulus rupture. This case demonstrates successful nonoperative management using pericardial drainage, blood transfusion, and recombinant activated factor VIIa.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter aortic valve replacement (TAVR) is a key treatment for severe aortic stenosis in high-risk patients.
- Managing TAVR complications is challenging due to high mortality risks with surgical conversion.
Observation:
- A patient undergoing TAVR experienced a rare complication: aortic annulus rupture.
- Immediate surgical conversion was deemed too high-risk for this patient.
Findings:
- Successful nonoperative management was achieved through prompt pericardial drainage.
- Adjunctive therapies included blood product transfusion and recombinant activated factor VIIa administration.
Implications:
- This case highlights a viable nonoperative strategy for TAVR-related aortic annulus rupture.
- It expands treatment options for TAVR complications in high-risk individuals.
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