Department of Cardiology, The Second Affiliated Hospital of Nanchang University, 330006, Nanchang, Jiangxi, China.
Catheter Cardiovasc Interv. 2022 Oct;100(4):674-678. doi: 10.1002/ccd.30353. Epub 2022 Aug 3.
Annular rupture is a rare and dreaded complication of transcatheter aortic valve replacement (TAVR) and even rarer when caused by predilatation balloon aortic valvuloplasty. This complication often presents as sudden cardiac tamponade with hypotension and requires urgent intervention. The traditional rescue strategy for patients with annular rupture is emergency surgical repair. However, the mortality rate is still high, considering that most patients who undergo TAVR are not candidates for conventional cardiac surgery. Therefore, there is a need for additional emergency treatment strategies to decrease mortality. This report describes a case of predilatation-induced annular rupture during TAVR that was successfully sealed at the rupture site by valve implantation. This case suggests that continuing with valve deployment may be a successful treatment for predilatation-induced annular rupture during TAVR.
环状撕裂是经导管主动脉瓣置换术（TAVR）的一种罕见且可怕的并发症，而由预扩张球囊主动脉瓣成形术引起的环状撕裂则更为罕见。这种并发症常表现为心脏压塞导致低血压，需要紧急干预。对于环状撕裂患者，传统的抢救策略是紧急手术修复。然而，由于大多数接受 TAVR 的患者不符合传统心脏手术的条件，因此死亡率仍然很高。因此，需要额外的紧急治疗策略来降低死亡率。本报告描述了一例 TAVR 期间预扩张导致的环状撕裂，通过植入瓣膜成功封闭了撕裂部位。该病例提示，继续瓣膜扩张可能是 TAVR 期间预扩张导致的环状撕裂的一种成功治疗方法。
