JACC. Case reports · 2025
Unusual Case of Acute Type A Aortic Dissection During TAVR Bailout With a Self-Expanding Valve.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ma Lianyue, Liang Yongfeng, Gao Wei, Dong Mei, Liu Xiangjuan, Cao Yuan, Meng Xiao, An Guipeng
Аннотация
BACKGROUND: Over the past 2 decades, transcatheter aortic valve replacement (TAVR) has emerged as a widely accepted treatment for patients with severe aortic valve stenosis. Acute aortic dissection, although rare, is a life-threatening complication associated with TAVR.
CASE SUMMARY: An older man with severe aortic stenosis underwent TAVR. During valve deployment, catheter manipulation caused intimal disruption, leading to acute type A aortic dissection (TAAD). Remarkably, the dissection spontaneously sealed after prosthetic valve placement, thereby avoiding emergency surgery. A 6-month follow-up computed tomography angiography scan showed no extension of the dissection.
DISCUSSION: In the case we report, the dissection spontaneously sealed with the use of a prosthetic valve, a finding that reinforces the feasibility of nonsurgical management of iatrogenic TAAD during TAVR in select cases.
TAKE-HOME MESSAGE: The use of a biological valve offers a novel perspective on the conservative management of iatrogenic aortic dissection in high-risk patients during TAVR.
CASE SUMMARY: An older man with severe aortic stenosis underwent TAVR. During valve deployment, catheter manipulation caused intimal disruption, leading to acute type A aortic dissection (TAAD). Remarkably, the dissection spontaneously sealed after prosthetic valve placement, thereby avoiding emergency surgery. A 6-month follow-up computed tomography angiography scan showed no extension of the dissection.
DISCUSSION: In the case we report, the dissection spontaneously sealed with the use of a prosthetic valve, a finding that reinforces the feasibility of nonsurgical management of iatrogenic TAAD during TAVR in select cases.
TAKE-HOME MESSAGE: The use of a biological valve offers a novel perspective on the conservative management of iatrogenic aortic dissection in high-risk patients during TAVR.