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Plug Closure for Ascending Aortic Pseudoaneurysms After TAVI Using Self-Expandable Valve
Yoshiaki Katada1,2, Yoshihito Irie1, Yoshito Yamamoto3
1Department of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan.
Annals of Thoracic Surgery Short Reports
|January 10, 2025
Summary
Transcatheter aortic valve implantation (TAVI) can lead to aortic pseudoaneurysms. While plug closure can initially help, it may not be sufficient for long-term control, as demonstrated by a fatal case.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Transcatheter aortic valve implantation (TAVI) is a common procedure for aortic stenosis.
- Aortic pseudoaneurysms are a rare but serious complication following TAVI.
- The Evolut PRO valve is a widely used TAVI device.
Observation:
- A 90-year-old male developed ascending aortic pseudoaneurysms post-TAVI with an Evolut PRO valve.
- Initial plug closure of the pseudoaneurysms led to symptom improvement.
Findings:
- The patient experienced massive hemoptysis and died on postoperative day 4.
- Plug closure alone may not provide definitive control of aortic pseudoaneurysms after TAVI.
Implications:
- This case highlights the potential limitations of plug closure for managing TAVI-related aortic pseudoaneurysms.
- Further research into alternative or adjunctive treatment strategies is warranted.
- Careful patient selection and monitoring are crucial after TAVI.
