Key result
Aortic dissection after TAVR is rare but linked to ~40% in-hospital mortality.
Why the study?
Aortic dissection is a rare but catastrophic complication of TAVR, with limited data on mechanisms, management, and outcomes.
Observational (n=10)
No
Aortic dissection is a rare (0.38%) but catastrophic complication of TAVR with 40% early mortality, requiring prompt recognition and individualized multidisciplinary management.
Alerts clinicians to rare post-TAVR instability; leaves open optimal prevention strategies pending larger registries.
BACKGROUND: Aortic dissection is a rare but catastrophic complication of transcatheter aortic valve replacement (TAVR), with limited data on mechanisms, management, and outcomes. OBJECTIVES: To describe the incidence, mechanisms, management, and outcomes of aortic dissection complicating TAVR. METHODS: We retrospectively analyzed patients developing perioperative acute aortic dissection during TAVR between 2014 and September 2025. The primary outcome was in-hospital mortality. RESULTS: Among 2,646 TAVR procedures, 10 patients (0.38%) developed acute aortic dissection. Mean age was 83 ± 8 years, 70% were female, and mean Society of Thoracic Surgeons risk of mortality was 3.6% ± 3.4%. Six dissections (60%) were Stanford type A and 4 (40%) type B. Suspected mechanisms included delivery system manipulation (60%) and wire/catheter trauma (40%). Management consisted of open surgery (30%), endovascular/hybrid intervention (40%), or conservative treatment (30%). In-hospital and 30-day mortality were 40%. CONCLUSIONS: Aortic dissection after TAVR is rare but associated with substantial early mortality, requiring prompt recognition and individualized multidisciplinary management.
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Prochno et al. (2026) conducted an observational in Acute aortic dissection complicating transcatheter aortic valve replacement (TAVR) (n=10). Transcatheter aortic valve replacement (TAVR) was evaluated on In-hospital mortality. Aortic dissection after transcatheter aortic valve replacement is a rare complication occurring in 0.38% of procedures, but is associated with a high in-hospital mortality rate of 40%.
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