Late Type A Dissection After Transfemoral Aortic Valve Replacement

Michael E Pontious; Awais Ashfaq; Justin J Watson; Howard K Song; Cristina Fuss; Scott M Chadderdon; Castigliano M Bhamidipati

doi:10.1016/j.jaccas.2019.12.050

Late Type A Dissection After Transfemoral Aortic Valve Replacement

JACC Case Rep. 2020 Jun 17;2(6):877-881. doi: 10.1016/j.jaccas.2019.12.050. eCollection 2020 Jun.

Authors

Michael E Pontious¹, Awais Ashfaq², Justin J Watson², Howard K Song², Cristina Fuss³, Scott M Chadderdon⁴, Castigliano M Bhamidipati²

Affiliations

¹ School of Medicine, Oregon Health & Science University, Portland, Oregon.
² Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon.
³ Cardiothoracic Imaging, Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Oregon.
⁴ Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.

Abstract

An 87-year-old woman had residual moderate to severe aortic insufficiency following transcatheter aortic valve replacement. A year later, she developed extensive Stanford type A aortic dissection originating at the supra-annular aortic edge of the transcatheter aortic valve replacement nitinol frame. Dissection repair, frozen elephant trunk with exclusion of prior insufficiency while preserving the transcatheter aortic valve replacement valve was performed. (Level of Difficulty: Beginner.).

Keywords: STS-PROM, Society of Thoracic Surgeons predicted risk of mortality; TAAD, Stanford type A aortic dissection; TAVR, transcatheter aortic valve replacement; TEVAR, thoracic endovascular aortic repair; aortic valve; dissection; stenosis.

Publication types

Case Reports