Key result
Conservative management achieves complete resolution of post-TAVR ascending aortic dissection at 4 months.
Why the study?
Aortic dissection is a relatively rare but potentially lethal complication of TAVR.
Case Report (n=1)
No
Conservative management with discontinuation of anticoagulation may allow for complete spontaneous resolution of an iatrogenic ascending aortic dissection post-TAVR in a high-surgical-risk patient.
May support conservative management of select post-TAVR dissections; leaves open generalizability and safety beyond this case.
Transcatheter aortic valve replacement (TAVR) has shown good early and midterm results from high risk to low surgical risk patients with severe symptomatic aortic valve stenosis. Despite low adverse events, TAVR is associated with vascular injury, bleeding, stroke, and conduction system disturbances as the most common adverse events. Aortic dissection is a relatively rare but potentially lethal complication from TAVR. Here, we report a case of ascending aortic dissection (type A) complicating TAVR that was managed conservatively with complete resolution of the complication noted on serial computed tomography angiogram.
No takes yet. Share an insight, caveat, or question.
Sarmiento-Dickson et al. (2024) conducted a case report in Severe symptomatic aortic valve stenosis complicated by ascending aortic dissection after TAVR (n=1). Conservative management (discontinuation of anticoagulation and blood pressure control) was evaluated on Resolution of ascending aortic dissection on serial computed tomography angiogram. Conservative management, including strict blood pressure control and indefinite discontinuation of anticoagulation, resulted in the complete resolution of an iatrogenic ascending aortic dissection 4 months post-TAVR.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: