Elaine and Sydney Sussman Catheterization Laboratories, University of Miami Hospital, University of Miami Miller School of Medicine, Miami, Florida.
Catheter Cardiovasc Interv. 2018 Nov 15;92(6):1205-1208. doi: 10.1002/ccd.27546. Epub 2018 Feb 22.
Aortic annular rupture is one of the most feared complications of transcatheter aortic valve replacement (TAVR). This complication often presents as sudden cardiac tamponade with hypotension and requires urgent intervention. The traditional rescue strategy for such cases is emergency surgical intervention, yet the mortality remains high considering most patients who undergo TAVR are not candidates for open heart surgery. As such, there is a need for percutaneous alternatives to treat this critical complication. Here, we describe a case of annular rupture during TAVR that was successfully treated with coil embolization at the rupture site. This case illustrates the use of coil embolization as a treatment strategy in patients with acute aortic annular rupture who are at high-risk for surgical intervention.
主动脉瓣环破裂是经导管主动脉瓣置换术（TAVR）最可怕的并发症之一。这种并发症常表现为低血压导致的心脏压塞，需要紧急介入治疗。对于这种情况，传统的抢救策略是紧急外科手术干预，但考虑到大多数接受 TAVR 的患者都不适合进行心脏直视手术，死亡率仍然很高。因此，需要有经皮替代方法来治疗这种危急并发症。在这里，我们描述了一例 TAVR 期间发生的瓣环破裂，通过在破裂部位进行线圈栓塞治疗获得成功。该病例说明了线圈栓塞作为一种治疗策略在急性主动脉瓣环破裂患者中的应用，这些患者存在高风险的外科手术干预。
