Journal of Clinical Case Reports

Aortic Dissection after Transcatheter Aortic Valve Replacement: Conservative Approach with Good Outcome

Abstract

Šušteršič Miha, Zbačnik Rok, Lakič Nikola and Bunc Matjaž

An 80-year-old man with severe aortic stenosis, who declined aortic valve replacement several times since 2011 and had recurrent syncope after balloon aortic valvuloplasty, was admitted because of symptomatic aortic stenosis. A percutaneous strategy for his aortic stenosis was decided. Transcatheter aortic valve replacement using a balloon-expandable Edwards Sapien XT valve was performed under rapid ventricular pacing. After valve deployment, an aortic dissection of ascending aorta was noticed. There was no coronary flow compromise, no acute aortic root and ascending aorta dilatation, no pericardial effusion, and paravalvular aortic regurgitation was mild. After consultation with cardiovascular surgeon, interventional radiologist and invasive cardiologist we decided for conservative approach, with very good outcome and no additional disabilities in the follow up of more than two years.