Key result
Staged TEVAR followed by transapical TAVI successfully manages delayed thoracic aortic pseudoaneurysm after aborted TAVI.
Why the study?
Iatrogenic descending thoracic aortic pseudoaneurysms after aborted transfemoral TAVI attempts are rare and challenging to manage, with limited data on optimal treatment strategies.
Case Report (n=1)
This case report highlights that delayed iatrogenic descending thoracic aortic pseudoaneurysms after aborted TAVI can be safely and effectively managed with a staged TEVAR and transapical TAVI strategy in high-risk patients.
Iatrogenic aortic injury is a rare but life-threatening complication of transcatheter aortic valve implantation (TAVI). Descending thoracic aortic pseudoaneurysms are particularly uncommon and challenging to manage. We report an 88-year-old woman with prior type A dissection treated with a Bentall procedure and Carpentier-Edwards Perimount bioprosthesis, who developed severe valve stenosis. An initial transfemoral TAVI failed due to unfavorable descending thoracic aortic anatomy. One year later, angiography revealed a descending thoracic aortic pseudoaneurysm, which was likely related to the prior procedure. Given the high surgical risk, staged management was performed: thoracic endovascular aortic repair followed by successful transapical valve-in-valve TAVI.
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Bargagna et al. (2026) conducted a case report in Iatrogenic descending aortic pseudoaneurysm (n=1). Thoracic endovascular aortic repair (TEVAR) followed by transapical valve-in-valve TAVI was evaluated. A staged strategy of thoracic endovascular aortic repair followed by transapical valve-in-valve TAVI successfully treated a delayed descending thoracic aortic pseudoaneurysm after an aborted TAVI.
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