Journal
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
Volume 82, Issue 5, Pages E742-E746Publisher
WILEY-BLACKWELL
DOI: 10.1002/ccd.24524
Keywords
annular geometry; aortic stenosis; cardiac tamponade; computed tomography; transcatheter aortic valve
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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. (c) 2012 Wiley Periodicals, Inc.
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