Potential mechanism of annulus rupture during transcatheter aortic valve implantation.
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.
['Hayashida|Kentaro|K|', 'Bouvier|Erik|E|', 'Lefèvre|Thierry|T|', 'Hovasse|Thomas|T|', 'Morice|Marie-Claude|MC|', 'Chevalier|Bernard|B|', 'Romano|Mauro|M|', 'Garot|Philippe|P|', 'Farge|Arnaud|A|', 'Donzeau-Gouge|Patrick|P|', 'Cormier|Bertrand|B|']
D000369:Aged, 80 and over D001021:Aortic Valve D001024:Aortic Valve Stenosis D063126:Balloon Valvuloplasty D002114:Calcinosis D006328:Cardiac Catheterization D002305:Cardiac Tamponade D017809:Fatal Outcome D005260:Female D006341:Heart Rupture D019918:Heart Valve Prosthesis Implantation D006439:Hemodynamics D006801:Humans D008297:Male D061330:Multidetector Computed Tomography D012720:Severity of Illness Index D013997:Time Factors D016896:Treatment Outcome
transcatheter aortic valve computed tomography annular geometry aortic stenosis cardiac tamponade