Key result
Conservative management using a 'watchful waiting' approach successfully treated a late aortic root perforation following TAVR in a 78-year-old patient.
Why the study?
Aortic annulus rupture or aortic root perforation after TAVR usually requires emergent surgery with high mortality, but few cases may be managed conservatively under strict follow-up.
Case Report (n=1)
Late aortic root perforation following TAVR can sometimes be successfully managed conservatively with a watchful waiting approach guided by cardiac CT imaging.
May support watchful waiting in select late TAVR perforations; leaves open need for prospective validation.
Aortic annulus rupture or aortic root perforation is a rare complication of transcatheter aortic valve replacement (TAVR), requiring emergent cardiac surgery and carrying a high intraoperative mortality. Few cases can be managed conservatively, provided a strict clinical follow-up. This study describes the case of a 78-year-old patient with a degenerated bicuspid aortic valve stenosis who presented with a late aortic root perforation following TAVR, which was successfully managed applying a "watchful waiting" approach. Cardiac computed tomography imaging played a pivotal role in the diagnosis and subsequent decision on treatment and clinical follow-up.
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Costa et al. (2020) conducted a case report in Late aortic root perforation following TAVR (n=1). Conservative management ('watchful waiting') was evaluated. Conservative management using a 'watchful waiting' approach successfully treated a late aortic root perforation following TAVR in a 78-year-old patient.