Surgical Repair of a Transannular Rupture During Transfemoral Transcatheter Aortic Valve Replacement

Ryaan El-Andari; Sabin J Bozso; Jimmy Jh Kang; Vinod K Manikala; Michael C Moon; Mohammed Al-Aklabi; Robert C Welsh; Jeevan Nagendran

doi:10.1177/11795476211038126

Surgical Repair of a Transannular Rupture During Transfemoral Transcatheter Aortic Valve Replacement

Clin Med Insights Case Rep. 2021 Aug 6:14:11795476211038126. doi: 10.1177/11795476211038126. eCollection 2021.

Authors

Ryaan El-Andari¹, Sabin J Bozso², Jimmy Jh Kang², Vinod K Manikala², Michael C Moon², Mohammed Al-Aklabi², Robert C Welsh³, Jeevan Nagendran²

Affiliations

¹ Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
² Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
³ Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, AB, Canada.

Abstract

Annular rupture is a rare but life-threatening complication of transcatheter aortic valve replacement (TAVR). Mortality rates are high if immediate intervention, most often necessitating surgical repair, is not performed. Herein, we describe an 87-year-old man who, after deployment of TAVR, experienced acute decompensation and required urgent conversion to a midline sternotomy to repair an aortic annular rupture. This case demonstrates an example of a rare but severe complication of TAVR. This report provides an in-depth description of the surgical approach to repair an aortic annular rupture and demonstrates the utility of performing minimally invasive procedures inside a hybrid operating room.

Keywords: Transcatheter aortic valve replacement; annular rupture; aortic valve replacement.