Reports a rare case of late type A aortic dissection originating from a TAVR frame, successfully managed with surgical repair preserving the transcatheter valve.
May signal late dissection risk from TAVR frame in residual AI; leaves open optimal surveillance and valve-sparing strategies.
An 87-year-old woman had residual moderate to severe aortic insufficiency following transcatheter aortic valve replacement. A year later, she developed extensive Stanford type A aortic dissection originating at the supra-annular aortic edge of the transcatheter aortic valve replacement nitinol frame. Dissection repair, frozen elephant trunk with exclusion of prior insufficiency while preserving the transcatheter aortic valve replacement valve was performed. (Level of Difficulty: Beginner.)
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Pontious et al. (2020) studied this question.
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