A Rare Access Site Complication after Transcatheter Aortic Valve Implantation

Area of Science:

• Cardiology
• Gastroenterology
• Surgical Innovation

Background:

• Transfemoral access is the preferred route for transcatheter aortic valve implantation (TAVI) due to its minimally invasive nature and suitability for patients with appropriate vascular anatomy.
• Vascular complications are the most common issues associated with transfemoral access sites.

Observation:

• This report details an unusual case of colon perforation occurring after a transfemoral TAVI procedure.
• The complication was attributed to the patient's history of prior abdominal surgery, which altered their anatomy.

Findings:

• A patient with severe aortic stenosis underwent transfemoral aortic valve insertion.
• Following the procedure, the patient presented with acute abdomen, leading to the diagnosis of colonic perforation.
• Surgical intervention in the form of a hemicolectomy was required to address the perforation caused by femoral catheterization.

Implications:

• This case highlights a rare but serious gastrointestinal complication of transfemoral TAVI.
• It underscores the importance of considering patient history, particularly previous abdominal surgeries, when assessing risks for transfemoral procedures.
• Careful patient selection and awareness of potential non-vascular complications are essential for improving TAVI safety.