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04.10.2017 | short report | Ausgabe 23-24/2017

Wiener klinische Wochenschrift 23-24/2017

Rupture of the aortic root

A rare but life-threatening complication of transcatheter aortic valve replacement

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 23-24/2017
Autoren:
MD Christian Reiter, MD Michael Grund, MD Alexander Nahler, MD FESC Clemens Steinwender, MD FESC Thomas Lambert

Summary

Transcatheter aortic valve replacement (TAVR) has been shown to be a valid treatment option for patients with significant symptomatic aortic valve stenosis and high surgical risk. Rupture of the aortic root is a rare but life-threatening complication that occurs in approximately 1% of procedures and usually manifests as an acute complication at the time of valve implantation; however, physicians should be aware of a potentially subacute onset, since early recognition and immediate management are crucial. While many potential causes have been described, it is currently unknown which combinations will lead to its occurrence. Accurate preprocedural assessment of the aortic annulus and its adjacent structures as well as adequate sizing of the prosthetic valve are important steps to prevent rupture of the device landing zone.

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