Trans-apical stent-valve implantation for severe aortic stenosis in an 84-year-old female was complicated by a fatal, unexpected subaortic left ventricular free-wall rupture.
Case Report (n=1)
No
This is the first described case of a fatal subaortic left ventricular free-wall rupture occurring shortly after an otherwise uncomplicated trans-apical aortic valve implantation.
Our experience with the Sapien trans-apical aortic valve (Edwards Lifesciences Inc., Irvine, CA, USA) has been straightforward without per-procedural mortality except in 1/16 consecutive cases who developed non-apical haemorrhage early after valve implantation. We describe the case of an 84-year-old female carrying a very high operative risk (logistic EuroScore of 44%), who underwent a trans-apical stent-valve implantation for severe and symptomatic aortic valve stenosis (23 mm). Due to massive blood loss, an emergency sternotomy and cannulation for cardiopulmonary bypass resuscitation were necessary to treat (without success) an unusual and unexpected subaortic left ventricular free-wall rupture that occurred few minutes after the stent-valve positioning and implantation. To the best of our knowledge, this is the first described case of a left ventricular free-wall rupture occurring after an otherwise non-complicated standard catheter-based aortic valve replacement.
Ferrari et al. (Thu,) conducted a case report in Severe and symptomatic aortic valve stenosis (n=1). Sapien trans-apical aortic valve implantation was evaluated on Left ventricular free-wall rupture. Trans-apical stent-valve implantation for severe aortic stenosis in an 84-year-old female was complicated by a fatal, unexpected subaortic left ventricular free-wall rupture.