Outcomes in patients with contained ruptures of the aortic annulus after transcatheter aortic valve implantation with balloon-expandable devices

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  • Philipp Breitbart, Department of Cardiology & Angiology II, University Heart-Center Freiburg-Bad Krozingen, Germany.
  • ,
  • Jan Minners
  • ,
  • Gregor Pache
  • ,
  • Jochen Reinöhl
  • ,
  • Nicolaj Christopher Hansson
  • Bjarne L Nørgaard
  • ,
  • Franz-Josef Neumann
  • ,
  • Philipp Ruile

AIMS: To evaluate incidence and long-term outcomes of patients with contained ruptures of the aortic annulus (CR) after transcatheter aortic valve implantation (TAVI).

METHODS AND RESULTS: From May 2012 to June 2017 a total of 1030 patients underwent post- TAVI computed tomography angiography (CTA) at three centers in Germany and Denmark. CR were identified in 12 patients (1.2%, 80.7+5.0 years, STS-Score 4.1+1.4%). All 12 patients had received a balloon-expandable valve. In 3 patients periprocedural transesophageal echocardiography revealed findings suggestive of aortic dissection, an aortic intramural haematoma and/or a pericardial effusion. In the remaining 9 patients the rupture was an incidental finding on post-TAVI-CTA. During a median follow-up period of 2.5+1.5 years none of the patients reported symptoms related to the CR or had to undergo interventional or surgical treatment. Seven patients (58%) died from non-cardiac causes. In five patients follow-up-CTA was performed (287+218 days post-TAVI) with stable findings in three and complete remission in two patients.

CONCLUSIONS: A CR of the aortic annulus after TAVI was detected as a rare, predominantly incidental finding on post-TAVI-CTA. No adverse events related to the CR occurred during long- term follow-up. Our findings suggest a watch-and-wait strategy in these patients.

TidsskriftEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Sider (fra-til)1301-1303
StatusUdgivet - dec. 2017

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