Postprocedural ascending aortic dissection after transcatheter aortic valve implantation: a case report

Area of Science:

• Cardiology
• Vascular Surgery
• Interventional Cardiology

Background:

• Transcatheter aortic valve implantation (TAVI) is a standard treatment for severe aortic stenosis (AS).
• Vascular complications, including aortic dissection, are infrequent but potentially severe sequelae of TAVI.
• Ascending aortic dissection following TAVI is a rare event.

Observation:

• An 82-year-old female with severe AS and heart failure underwent TAVI.
• Pre-procedural CT revealed marked ascending aortic dilatation.
• The TAVI procedure was uneventful, with no immediate complications noted on transesophageal echocardiography.

Findings:

• The patient developed delayed ascending aortic dissection on postoperative day two.
• Computed tomography confirmed the dissection.
• Autopsy revealed significant fragility of the ascending aorta.

Implications:

• Severe aortic stenosis patients with aortic root dilatation may be at risk for delayed aortic dissection post-TAVI.
• This case highlights the importance of careful patient selection and monitoring for rare vascular complications.
• Further research is needed to identify risk factors and optimize management strategies for TAVI-related aortic complications.