Autopsy finding of the Sapien XT valve from a patient who died suddenly after transcatheter aortic valve replacement

Cardiovasc Interv Ther. 2013 Jul;28(3):267-71. doi: 10.1007/s12928-012-0153-9. Epub 2013 Jan 1.

Abstract

An 89-year-old woman with severe aortic stenosis underwent transfemoral aortic valve replacement. The postoperative course was uneventful except transient bradycardia immediately after the procedure. Echocardiographic finding showed excellent valvular function. After discharge, the patient died suddenly. Autopsy findings showed compression of the atrioventricular conduction system region at the septum by the stent strut. Microscopic examination showed atrophy of the conduction fibers with eosinophilic degeneration of the cytoplasm or coagulation necrosis with pyknosis in the bundle of His and the left bundle branch. Compression by the stent strut triggering dysfunction of the conduction system could have caused fatal arrhythmic event.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Valve / pathology*
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / surgery*
  • Autopsy
  • Cardiac Catheterization*
  • Fatal Outcome
  • Female
  • Heart Valve Prosthesis*
  • Humans