Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Jun 17;2(6):877-881.
doi: 10.1016/j.jaccas.2019.12.050. eCollection 2020 Jun.

Late Type A Dissection After Transfemoral Aortic Valve Replacement

Michael E Pontious  1 , Awais Ashfaq  2 , Justin J Watson  2 , Howard K Song  2 , Cristina Fuss  3 , Scott M Chadderdon  4 , Castigliano M Bhamidipati  2
Affiliations
Case Reports

Late Type A Dissection After Transfemoral Aortic Valve Replacement

Michael E Pontious et al. JACC Case Rep. .

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.

PubMed Disclaimer

Figures

None
Graphical abstract
Figure 1
Figure 1
Reconstructed CTA Images of Aortic Dissection (A) Reconstructed sagittal view of gated computed tomography chest angiogram demonstrating type A aortic dissection with contrast extravasation. (B) Reconstructed sagittal view of gated computed tomography chest angiogram demonstrating descending aortic dissection with contrast extravasation.
Figure 2
Figure 2
Intraoperative Image of Type A Aortic Dissection Intraoperative image following cannulation on cardiopulmonary bypass of the CoreValve imprinted onto the ascending aorta (∗) imminently pending rupture.
Figure 3
Figure 3
Illustration of Repair Technique (A) Schematic of dissection location. (B) Repair strategy of aortic dissection, preserving the CoreValve. (C) Repair strategy of aortic insufficiency under the CoreValve skirt and the native aortic valve annular plane.
See this image and copyright information in PMC

References

    1. Bonser R.S., Ranasinghe A.M., Loubani M. Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection. J Am Coll Cardiol. 2011;58:2455–2474. - PubMed
    1. Plichta R.P., Hughes G.C. Thoracic endovascular aortic repair for the ascending aorta: experience and pitfalls. J Vis Surg. 2018;4:92. - PMC - PubMed
    1. Berfield K.K., Sweet M.P., McCabe J.M. Endovascular repair for type A aortic dissection after transcatheter aortic valve replacement with a Medtronic CoreValve. Ann Thorac Surg. 2015;100:1444–1446. - PubMed
    1. Ong S.H., Mueller R., Gerckens U. Iatrogenic dissection of the ascending aorta during TAVI sealed with the CoreValve revalving prosthesis. Catheter Cardiovasc Interv. 2011;77:910–914. - PubMed
    1. Mangla A., Gupta S. Vascular complications post-transcatheter aortic valve procedures. Indian Heart J. 2016;68:724–731. - PMC - PubMed

Publication types

LinkOut - more resources