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Disyección aórtica con formación de pseudoaneurisma disfrazado de embolia pulmonar después del reemplazo de la
Heather Wang1, Juan Bello1, Dhir Gala1
1Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.
Resumen
Una complicación rara después del reemplazo de la válvula aórtica transcatéter (TAVR) es la disección aórtica, que puede presentarse semanas más tarde con síntomas que imitan otras afecciones. Este caso pone de relieve los desafíos del diagnóstico tardío para este evento post-TAVR grave.
Área de la Ciencia:
- Medicina cardiovascular
- Cardiología intervencionista
- Imágenes médicas
Sus antecedentes:
- El reemplazo de la válvula aórtica transcatéter (TAVR) es un tratamiento estándar para la estenosis aórtica grave.
- Aunque generalmente es seguro, pueden ocurrir complicaciones raras como la disección aórtica después de la TAVR.
- La presentación tardía de complicaciones puede plantear desafíos de diagnóstico.
Objetivo del estudio:
- Para reportar un caso único de disección aórtica retrasada después de TAVR.
- Para resaltar las dificultades de diagnóstico asociadas con las raras complicaciones post-TAVR.
- Hacer hincapié en la importancia de considerar las complicaciones tardías en el tratamiento del paciente.
Principales métodos:
- Informe de caso de una paciente inmunocomprometida de 75 años.
- Presentación clínica detallada que incluye disnea, dolor en el pecho e hipoxia.
- Examen de diagnóstico que incluye imágenes para investigar la sospecha de embolia pulmonar y la patología aórtica subsiguiente.
Principales resultados:
- La sospecha inicial de embolia pulmonar no fue resuelta por la anticoagulación.
- El paciente desarrolló anemia aguda, lo que provocó una investigación adicional.
- Se identificó un aneurisma aórtico torácico ascendente y una disección con pseudoaneurisma que causa obstrucción de la arteria pulmonar derecha.
Conclusiones:
- La disección aórtica es una rara pero grave complicación tardía de la TAVR.
- Los desafíos de diagnóstico surgen de presentaciones atípicas y síntomas superpuestos.
- Los médicos deben mantener un alto índice de sospecha de complicaciones posteriores a la TAVR, incluso semanas después del procedimiento.
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