Key result
An 82-year-old woman with severe aortic stenosis and aortic root dilatation developed a fatal delayed-onset ascending aortic dissection on the second postoperative day after TAVI.
Why the study?
Aortic dissection is a rare but serious consequence after TAVI, and the authors report a case of delayed-onset ascending aortic dissection following the procedure.
Case Report (n=1)
Highlights the rare but fatal risk of delayed ascending aortic dissection following TAVI in patients with pre-existing aortic root dilatation.
Delayed aortic dissection post-TAVI warrants clinical vigilance; this case leaves open incidence and surveillance needs.
Background: Transcatheter aortic valve implantation (TAVI) has been established as an effective and safe treatment for patients with severe aortic stenosis (AS). It is reported that vascular complications, especially aortic dissection, are rare. However, aortic dissection may be a serious consequence if it occurs. We experienced a case of delayed onset of ascending aortic dissection after TAVI. Case summary: An 82-year-old woman presented with dyspnoea and general fatigue. Echocardiography revealed severe AS and she was diagnosed with heart failure associated with AS. She had difficulty controlling heart failure and required the intervention of the aortic valve. We evaluated the aortic valve and access routes with contrast-enhanced computed tomography (CT), which showed marked dilatation of the ascending aorta. Transcatheter aortic valve implantation was performed and the procedure was completed without major complications. Transoesophageal echocardiography during the procedure did not detect any obvious arterial injury. However, on the second postoperative day, the patient suddenly became unconscious and a CT indicated an ascending aortic dissection. Unfortunately, she passed away. An autopsy revealed the fragility of the ascending aorta. Conclusion: Patients with AS and aortic root dilatation may develop delayed onset of ascending aortic dissection after TAVI.
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Fujita et al. (2022) conducted a case report in Severe aortic stenosis (n=1). Transcatheter aortic valve implantation (TAVI) was evaluated on Ascending aortic dissection. An 82-year-old woman with severe aortic stenosis and aortic root dilatation developed a fatal delayed-onset ascending aortic dissection on the second postoperative day after TAVI.
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