Why the study?
Does conservative management successfully treat aortic root rupture complicated with cardiac tamponade following TAVI?
Does conservative management successfully treat aortic root rupture complicated with cardiac tamponade following TAVI?
Conservative management with pericardial drainage, auto-transfusion, and anticoagulation reversal may be a viable initial strategy to avoid emergent surgery in patients with aortic root rupture and cardiac tamponade during TAVI.
Conservative management may avoid surgery in select TAVI ruptures; leaves open need for prospective validation before practice change.
Aortic root rupture and cardiac tamponade during transcatheter aortic valve implantation is a frightening complication with high mortality rate. A conservative management of this complication could represent an initial strategy, especially in high-risk patients, to avoid emergent cardiac surgery. This conservative management includes: Immediate detection of pericardial effusion by echocardiography, a fast instauration of pericardial drainage, auto-transfusion and anticoagulation reversal. We describe two cases of patients who suffered this complication and were treated successfully with this initial approach.
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Vannini et al. (2017) studied this question.
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