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Pneumothorax-I01:26

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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
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A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application
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Balloon rupture during transcatheter aortic valve replacement.

Craig Basman1, David Landers1, Chad Kliger2

  • 1Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 28, 2024
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Summary

Balloon rupture during transcatheter heart valve (THV) deployment is a rare but serious complication. Preoperative computed tomography (CT) helps identify high-risk patients to prevent stroke and other injuries.

Keywords:
SapienTAVRballoon rupturepercutaneous retrievaltranscatheter aortic valve replacement

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Balloon-expandable (BE) transcatheter heart valve (THV) systems, like the Edwards Sapien, carry a risk of balloon rupture during deployment.
  • Balloon rupture can lead to severe complications including stroke, incomplete valve expansion, and vascular injury.

Purpose of the Study:

  • This review aims to elucidate the mechanisms of balloon rupture during THV deployment.
  • It also seeks to outline strategies for identifying high-risk patients, mitigating rupture risks, and managing complications.
  • Percutaneous retrieval strategies for ruptured balloons are also discussed.

Main Methods:

  • Review of existing literature on balloon-expandable THV systems.
  • Analysis of reported cases of balloon rupture and associated complications.
  • Discussion of imaging modalities, particularly preoperative computed tomography (CT), for risk assessment.

Main Results:

  • Annular and left ventricular outflow tract (LVOT) calcification are known risk factors for balloon injury.
  • Balloon injury can occur at various anatomical locations, not limited to the LVOT.
  • Early identification of risk factors and implementation of preventative measures are crucial.

Conclusions:

  • Careful preoperative assessment using CT is essential for identifying patients at high risk of balloon rupture.
  • Understanding the mechanisms and risk factors allows for proactive management strategies.
  • Effective percutaneous retrieval techniques are vital for managing intraprocedural balloon rupture.