- 著者
-
Yasuo Tsuru
Mizuki Miura
Shinichi Shirai
Masaomi Hayashi
Kenji Taninobu
Hiroshi Takiguchi
Shinya Ito
Mariko Yano
Tomohiro Kawaguchi
Takashi Morinaga
Akihiro Isotani
Shinichi Kakumoto
Katsuhiro Seo
Yoshio Arai
Genichi Sakaguchi
Kenji Ando
- 出版者
- International Heart Journal Association
- 雑誌
- International Heart Journal (ISSN:13492365)
- 巻号頁・発行日
- pp.18-484, (Released:2019-04-25)
- 参考文献数
- 18
- 被引用文献数
-
3
Aortic complex rupture is one of the most critical complications associated with transcatheter aortic valve implantation (TAVI). Its incidence is rare, and its mechanism varies by case; therefore, it is difficult to identify the predictors of complex rupture. Herein, we report a clinical case series of aortic complex rupture. Within our cohort, the frequency of complex rupture was 0.8% (4/497 consecutive patients) with an in-hospital mortality of 0. Among these four patients with complex rupture, two underwent emergent thoracotomy and surgical hemostasis without a heart-lung machine and surgical aortic valve replacement, whereas the other two were conservatively managed. The case overview revealed the following similarities: all the patients were elderly, small women; balloon-expandable valves were used; the annulus area was small with heavily calcified leaflet; and aggressive treatment strategy was used (i.e., oversizing and post-dilatation). In such cases, TAVI should be performed with a careful strategy. Once aortic complex rupture occurs, damage can be minimized through cooperation with an institutional heart team and calm management.