Annular rupture occurs in approximately 1% of transcatheter aortic valve replacement cases. Annular rupture often requires surgical management and is associated with high mortality. Repair of annular rupture in patients with previous coronary artery bypass grafting (CABG) is undercharacterized and poses a unique challenge given the increased difficulty and complexity from both an emergent and reoperative case. An 80-year-old male with previous CABG experienced annular rupture post-transcatheter aortic valve replacement requiring urgent surgical management. This case illustrates the successful repair of a rare and high-risk complication describing the approach utilized in correcting annular rupture in a patient with previous CABG.
Keywords: CABG; TAVR; annular rupture; aortic valve; reoperation.
Damage to the base of the main blood vessel supplying blood to the body (the aortic annulus) after transcatheter aortic valve replacement (TAVR), a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly, is rare. Annular rupture, a term used for injuries that occur in the region of the base of the aorta during TAVR, often needs surgical management. It also carries a high risk of death. Repair of annular rupture in patients with previous coronary bypass surgery, a surgery used to treat coronary heart disease, a condition where blood vessels of the heart become narrowed due to a buildup of fatty material within their walls, is not well described and poses a unique challenge. An 80-year-old male with previous bypass surgery had an annular rupture after TAVR requiring urgent surgery. This case illustrates the successful repair of a rare and high-risk complication. This case report also describes the approach for correcting this complication in a patient with previous bypass surgery.