Key result
Elective TEVAR successfully treats delayed remodeling from TAVI-induced type B aortic dissection.
Why the study?
Catheter-induced type B aortic dissection is a rare complication of transcatheter aortic valve implantation with uncertain long-term behavior.
Case Report (n=1)
In catheter-induced type B aortic dissection after TAVI, clinical stability does not guarantee aortic wall healing, and long-term serial CTA surveillance is essential to detect silent adverse remodeling and guide timely elective thoracic endovascular aortic repair.
May support serial CTA surveillance for stable catheter-induced type B dissection post-TAVI; leaves open natural history and intervention thresholds.
BACKGROUND: Catheter-induced type B aortic dissection is a rare complication of transcatheter aortic valve implantation with uncertain long-term behavior. CASE SUMMARY: An 85-year-old woman developed a focal aortic isthmus dissection during transfemoral transcatheter aortic valve implantation. Initial computed tomography angiography (CTA) showed no malperfusion or rupture; conservative management and serial CTA surveillance were selected. Despite persistent clinical stability, follow-up CTA demonstrated progressive focal outpouching and pseudoaneurysmal remodeling. At 17 months, elective thoracic endovascular aortic repair achieved complete exclusion of the lesion. DISCUSSION: Catheter-induced dissection may represent a mechanistically distinct entity from spontaneous type B aortic dissection, limiting direct extrapolation of conventional management pathways. Morphological progression, rather than symptoms or absolute aortic diameter, prompted intervention. TAKE-HOME MESSAGES: Clinical stability does not establish aortic wall healing. Long-term serial CTA can identify silent adverse remodeling and guide elective thoracic endovascular aortic repair in selected patients.
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Bargagna et al. (2026) conducted a case report in Catheter-induced type B aortic dissection after transcatheter aortic valve implantation (n=1). Conservative management with serial CTA surveillance followed by elective thoracic endovascular aortic repair was evaluated on Exclusion of pseudoaneurysmal lesion on CTA. Elective thoracic endovascular aortic repair at 17 months achieved complete exclusion of a TAVI-induced type B dissection in 1 patient after serial CTA detected silent remodeling.
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