Balloon rupture during transcatheter aortic valve replacement
Corresponding Author
Craig Basman MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Correspondence Craig Basman, MD, Division of Cardiology, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ 07601, USA.
Email: [email protected] and [email protected]
Search for more papers by this authorDavid Landers MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorChad Kliger MD
Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, New York, USA
Search for more papers by this authorKarla Rodriguez-Barragan MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorSung-Han Yoon MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorHaroon Faraz MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorAnkitkumar Patel MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorYuriy Dudiy MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorMark Anderson MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorRyan Kaple MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorCorresponding Author
Craig Basman MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Correspondence Craig Basman, MD, Division of Cardiology, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ 07601, USA.
Email: [email protected] and [email protected]
Search for more papers by this authorDavid Landers MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorChad Kliger MD
Department of Cardiothoracic Surgery, Lenox Hill Hospital, New York, New York, USA
Search for more papers by this authorKarla Rodriguez-Barragan MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorSung-Han Yoon MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorHaroon Faraz MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorAnkitkumar Patel MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorYuriy Dudiy MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorMark Anderson MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorRyan Kaple MD
Department of Cardiology and Cardiothoracic Surgery, Hackensack University Medical Center, Hackensack, New Jersey, USA
Search for more papers by this authorAbstract
A distinctive complication with balloon-expandable (BE) THV platforms such as the Edwards Sapien (Edwards Lifescience) is the possibility of balloon rupture during THV deployment. Balloon rupture is a rare occurrence that can result in stroke due to fragment embolism, incomplete THV expansion, and/or vascular injury upon retrieval of the balloon. Careful evaluation of preoperative computed tomography is essential to identify high-risk cases. While annular and left ventricular outflow tract (LVOT) calcification are widely acknowledged as common risks for balloon injury, it's essential to note that balloon injury can manifest at various anatomical sites. In this review, we discuss the mechanism behind balloon rupture, methods to identify cases at a heightened risk of balloon injury, approaches to mitigate the risk of rupture, and percutaneous retrieval strategies.
CONFLICT OF INTEREST STATEMENT
Ryan Kaple is a speaker for Edwards Lifesciences and Abbott. Ankitkumar Patel is a speaker for Edwards Lifesciences, Medtronic, and Abbott. The other authors declare no conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| ccd31029-sup-0001-Video_1.mp413.1 MB | Video 1: After horizontal rupture, the balloon is unable to be retrieved into the E-sheath ex-vivo. |
| ccd31029-sup-0002-Video_2.mp411.6 MB | Video 2: With aggressive pulling, the shaft of the balloon can fracture. The distal portion will only be connected to the inner balloon shaft via the balloon coils. |
| ccd31029-sup-0003-Video_3.mp446.3 MB | Video 3: A torturous and calcified aorta. There is protruding calcium deposits near the area of aorta kink, so balloon alignment is performed below the kink. Careful attention to advance the delivery system across the aorta and avoid heavy areas of plaque. |
| ccd31029-sup-0004-Video_4.mov11.9 MB | Video 4: An example showing that by separating the inner balloon shaft from the pusher, the distal balloon can be retrieved from the contralateral side. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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