Among 1335 consecutive patients who underwent TAVR in 2013–2021, we retrospectively extracted 13 patients (1.0%) with TAVR-related AD (Stanford type A in 6 [46%], type B in 7 [54%]). AD was defined as a new-onset dissected layer of the aortic wall and diagnosed by aortography, computed tomography, or transesophageal echocardiography.

Results

Five of the six type A AD cases (83%) were detected during TAVR versus only one of the seven type B AD cases (14%). Four of the seven type B AD cases (57%) were asymptomatic and incidentally detected on computed tomography. The presumed causes of AD were injury by the delivery sheath (39%), delivery catheter (23%), valve implantation (15%), stent edge (15%), and pre-dilation balloon (8%). Complicated AD occurred in only one patient (8%). Considering the patient's age and prohibitive surgical risk, all patients were treated conservatively and free of any aortic-related deaths or interventions during a follow-up of 1087 days.

Conclusions

TAVR-related AD is a rare but life-threatening condition that may be underdiagnosed. Its optimal therapy remains unclear, and conservative management might be an option for selected patients. Further studies are needed to elucidate the incidence, risk factors, effective screening, optimal therapy, and outcomes of TAVR-related AD.

Open Research

DATA AVAILABILITY STATEMENT

Data cannot be made publicly available for ethical reasons, for example, public availability would compromise patient confidentiality.

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Volume101, Issue3

February 15, 2023

Pages 668-675

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Transcatheter aortic valve replacement-related aortic dissection: A clinical case series

Abstract

Objectives

Background

Methods

Results

Conclusions

Open Research

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REFERENCES

Citing Literature

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Transcatheter aortic valve replacement-related aortic dissection: A clinical case series

Abstract

Objectives

Background

Methods

Results

Conclusions

Open Research

DATA AVAILABILITY STATEMENT

REFERENCES

Citing Literature

References

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