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. 2023 Jul 11;7(6):100205.
doi: 10.1016/j.shj.2023.100205. eCollection 2023 Nov.

Transcatheter Closure of Aortic Root Rupture and Pseudoaneurysm After Surgical Implantation of Transcatheter Valve in Native Mitral Annular Calcification With Concomitant Surgically Implanted Transcatheter Aortic Valve

Alexander Cubberley  1 , Rahul Sawhney  1 , Paul Grayburn  1   2 , Ambarish Gopal  1 , Justin Schaffer  3 , Robert L Smith  3 , Molly Szerlip  2 , Srinivasa Potluri  2
Affiliations

Transcatheter Closure of Aortic Root Rupture and Pseudoaneurysm After Surgical Implantation of Transcatheter Valve in Native Mitral Annular Calcification With Concomitant Surgically Implanted Transcatheter Aortic Valve

Alexander Cubberley et al. Struct Heart. .
No abstract available

Keywords: Aortic rupture; Paravalvular leak closure; Pseudoaneurysm; SITRAL; TAVR.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Computed tomography heart demonstrating severe circumferential mitral annular calcification extending into aortic annulus.
Figure 2
Figure 2
Intraoperative images of surgically implanted Sapien 3 transcatheter valve in mitral position (SITRAL) from below the aortic valve (left). SITRAL and Sapien 3 transcatheter valve in the aortic position viewed through aortotomy.
Figure 3
Figure 3
Computed tomography heart after initial surgical repair of the mitral regurgitation and aortic stenosis with Sapien 3 valve in the mitral and aortic position. Aortic annular rupture with significant aorta to left ventricle pseudoaneurysm adjacent to Sapien valve in the aorta (white arrows).
Figure 4
Figure 4
Intervention on pseudoaneurysm. Angiogram demonstrating aortic rupture and contrast through the pseudoaneurysm (arrow) to LV around the aortic position Sapien valve. (a) Safety wire from aorta through the pseudoaneurysm into LV, back through the center of the aortic position Sapien valve in ascending aorta (b). Safety wire snared to descending aorta (c). Microcatheter in pseudoaneurysm with placement of Amplatzer Plug (arrow) from aorta through the pseudoaneurysm into LV (d and e). Amplatzer Plug (Abbott) and distal coils (Terumo) in pseudoaneurysm (f). Abbreviation: LV, left ventricle.
Figure 5
Figure 5
Final result after intervention: Amplatzer Plug (Abbot) and distal coils (Terumo) in the pseudoaneurysm adjacent to the aortic position Sapien transcatheter valve (Edwards).
Figure 6
Figure 6
TEE 6 weeks after index procedure (SITRAL-TAVR) demonstrating pseudoaneurysm from aorta to LV adjacent to aortic Sapien transcatheter valve (arrow) (a-c). Postintervention TEE demonstrating Amplatzer Plug (arrow) and coiling of pseudoaneurysm with reduced flow around Sapien transcatheter valve (d-f). Abbreviations: TAVR, transcatheter aortic valve replacement; TEE, transesophageal echocardiogram.
Figure 7
Figure 7
Follow-up CT heart 6 months after intervention showing Sapien valves with occlusion of pseudoaneurysm (arrows) by Amplatzer Plug and coils (left, middle). 3 dimensional CT reconstruction showing Sapien valves (aortic valve-top, mitral valve-bottom) with closure of pseudoaneurysm (arrow, right). Abbreviation: CT, computed tomography.
See this image and copyright information in PMC

References

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