A novel surgical approach combined with prior PCI using endothelial progenitor cell-capturing stents successfully managed a typically fatal aortic root rupture during TAVI.
May salvage typically fatal aortic root rupture during TAVI; leaves open generalizability beyond this single case.
Aortic root rupture during transcatheter aortic valve implantation (TAVI) is an uncommon but almost uniformly fatal complication. We describe a novel surgical management of this complication using a combination of pledgeted sutures and prolonged direct digital compression with biomatrix and lattice adjuncts. Furthermore, our patient underwent percutaneous coronary intervention with endothelial progenitor cell-capturing stents, which facilitated TAVI to be performed off clopidogrel therapy. We believe the use of these stents reduced the severity of hemorrhage following aortic root rupture and helped maintain vessel patency following prolonged hypotension.
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Lee et al. (2012) studied this question.
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