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CASE REPORT   

Chirurgia 2021 February;34(1):41-3

DOI: 10.23736/S0394-9508.20.05100-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Prosthesis valve dislocation and acute ascending aortic dissection during transcatheter self-expandable aortic valve replacement

Satoshi YAMASHIRO , Yuya KISE, Hitoshi INAFUKU, Takaaki NAGANO, Yukio KUNIYOSHI

Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan



An 89-year-old man who presented with severe aortic valve stenosis was treated due to advanced age, by transcatheter aortic valve replacement using a self-expandable valve. The prosthetic valve moved above the annulus during placement and migrated distally, settling into the sinus of Valsalva. We re-implanted a new self-expandable valve through the primary implanted valve. Thereafter, the hemodynamics of the patient stabilized without catecholamine support. However, computed tomography findings at two hours after the procedure revealed acute type A aortic dissection, and open conversion proceeded immediately. We achieved ascending aortic replacement with aortic valve replacement after removing the implanted self-expandable valve. The postoperative course was uneventful. While transcatheter aortic valve replacement has gained popularity as an alternative to surgery for patients with severe aortic stenosis and high operative risk, successful surgical outcomes of acute type A aortic dissection arising during replacement are rare.


KEY WORDS: Aortic valve stenosis; Transcatheter aortic valve replacement; Aneurysm, dissecting

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