Transcatheter Aortic Valve Implantation Complicated With Asymptomatic Left Ventricular Dissection and Conservative Management

Author(s)

Abstract
Over the last decade, transcatheter aortic valve implantation (TAVI) has emerged as a valuable and safe alternative to surgical aortic valve replacement (SAVR), nevertheless, major complications still occur in ≤6% to 8% of cases. Such major complications have been associated with a 2- to 3-fold increase in 30-day mortality. 1 We describe a case of TAVI complicated with asymptomatic left ventricular dissection in whom a transcatheter aortic valve was successfully implanted but on the control Echcoardiogram, free wall dissection was observed. No segmentary movement disorders were observed, neither EKG changes. Conservative management was opted with no further complications. The 30-day follow up revealed a left-ventricle aneurysm but improvement to functional class I was seen. The patient 12 months post-TAVR remains asymptomatic and on Class I NYHA. No changes on gradient, ejection fraction or paravalvular leak have been registered.The management of left ventricular injuries is highly specific and depends on the type of lesion, the wound location, the patient’s clinical status, and the patient’s overall health status and ability to tolerate an open repair. We can conclude that it is feasible to maintain a conservative and expectant management in this type of complications as long as pseudoaneurysm or pericardial effusion are ruled out and the patient remains hemodynamically stable.

Keywords
TAVI, ventricular dissection, complications, treatment

Cite this paper
Allende-Carrera, Ricardo, Aguilar-Rojas, Luis Antonio, Transcatheter Aortic Valve Implantation Complicated With Asymptomatic Left Ventricular Dissection and Conservative Management , SCIREA Journal of Medicine. Volume 5, Issue 2, April 2021 | PP. 11-15. 10.54647/pm31118

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