Acute Stanford Type A Aortic Dissection After Transcatheter Aortic Valve Implantation Necessitating the Bentall Procedure: A Case Report.

An 80-year-old female with a history of sarcoidosis, dyslipidemia, hypertension, and permanent pacemaker implantation for complete atrioventricular block, presented with severe calcified aortic stenosis, corresponding to New York Heart Association Class II-III heart failure. The patient subsequently underwent elective transcatheter aortic valve implantation (TAVI) using a self-expandable transcatheter heart valve. After valve deployment, transesophageal echocardiography revealed a flap in the ascending aorta. Contrast-enhanced computed tomography (CECT) confirmed the diagnosis of Stanford Type A acute aortic dissection, and emergency surgery was indicated based on the presumed injury to the sinus of Valsalva caused by pop-out and recapture maneuvers during TAVI. Intra-operative findings revealed a transverse intimal tear extending across the right coronary and non-coronary cusps, necessitating aortic root replacement (Bentall procedure) and concomitant coronary artery bypass grafting to the right coronary artery.