Acute Iatrogenic Aortic Root Dissection With Pseudoaneurysm After Transcatheter Aortic Valve Implantation

Figures

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  Visual Summary. Timeline CABG = coronary artery bypass grafting; CT = computed tomography; DOAC = direct oral anticoagulant; F/U = follow-up; POD = postoperative day; TAVI = transcatheter aortic valve implantation.

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  Figure 1. Preprocedural Imaging Evaluation for Aortic Valve Intervention Preprocedural aortic valve evaluation (A) from computed tomography, showing axial and coronal views for TAVI planning, with (B) 3-dimensional reconstruction of the aortic anatomy for spatial assessment, and (C) detailed measurements. (D) Angiographic imaging simulation with aortic angulation of 52°.

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  Figure 2. Fluoroscopic Visualization of Valve Deployment in the Aortic Annulus Deployment of the 29-mm Evolut FX valve within the aortic annulus complex, visualized with procedural contrast fluoroscopy.

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  Figure 3. Serial CT Imaging of Aortic Dissection Progression Following TAVI Postprocedural computed tomographic (CT) assessments of aortic dissection progression (A) immediately after TAVI and (B) on the second day after TAVI. (C) Three-dimensional aortic anatomy reconstruction on the second day after TAVI. (D) CT on the fourth day after TAVI.

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  Figure 4. Echocardiographic Doppler Assessment Showing Mild Paravalvular Leak 1-Day Post-TAVI Transthoracic echocardiography with color Doppler demonstrating mild paravalvular leak at the 3 o’clock position on postoperative day 1.

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  Figure 5. Computed Tomography Demonstrating Complete Resolution of Aortic Dissection After TAVI (A) Postprocedural computed tomography showing complete aortic dissection resolution on the eleventh day following TAVI and (B) 3-dimensional aortic anatomy reconstruction at the latest follow-up (1.5 months after TAVI).