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Potential mechanism of annulus rupture during transcatheter aortic valve implantation
Author(s) -
Hayashida Kentaro,
Bouvier Erik,
Lefèvre Thierry,
Hovasse Thomas,
Morice MarieClaude,
Chevalier Bernard,
Romano Mauro,
Garot Philippe,
Farge Arnaud,
DonzeauGouge Patrick,
Cormier Bertrand
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24524
Subject(s) - medicine , cardiac skeleton , annulus (botany) , calcification , cardiology , complication , tamponade , aortic valve , hemodynamics , balloon , surgery , radiology , aortic valve replacement , stenosis , botany , biology
Although annulus rupture is one of the most severe complications of transcatheter aortic valve implantation (TAVI), the incidence and mechanism of this complication remain unclear. Out of 387 consecutive TAVI cases in our institution, the incidence of annulus rupture was 1.0% (4/387). The first two patients died because of hemodynamic collapse due to tamponade on day 0. Both surviving patients had undergone preprocedural multidetector computed tomography which revealed large calcifications in the epicardial fat part of the aortic annulus. In both cases, annulus rupture occurred after deployment of a balloon expandable valve suggesting that mechanical compression of this “vulnerable area” by calcification may cause annulus rupture. © 2012 Wiley Periodicals, Inc.