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Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair

BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) continues to grow worldwide. Despite increased operator experience, evolution of the technique, and deflectable catheters, major complications still occur in ≤ 6% up to 8% of cases. Such major complications have been associated wi...

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Autores principales: Nasso, Giuseppe, Santarpino, Giuseppe, Contegiacomo, Gaetano, Balducci, Giuseppe, Valenzano, Antongiulio, Moranti, Enrico, Scaringi, Domenico, Speziale, Giuseppe, Condello, Ignazio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261075/
https://www.ncbi.nlm.nih.gov/pubmed/35794658
http://dx.doi.org/10.1186/s13019-022-01925-4
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author Nasso, Giuseppe
Santarpino, Giuseppe
Contegiacomo, Gaetano
Balducci, Giuseppe
Valenzano, Antongiulio
Moranti, Enrico
Scaringi, Domenico
Speziale, Giuseppe
Condello, Ignazio
author_facet Nasso, Giuseppe
Santarpino, Giuseppe
Contegiacomo, Gaetano
Balducci, Giuseppe
Valenzano, Antongiulio
Moranti, Enrico
Scaringi, Domenico
Speziale, Giuseppe
Condello, Ignazio
author_sort Nasso, Giuseppe
collection PubMed
description BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) continues to grow worldwide. Despite increased operator experience, evolution of the technique, and deflectable catheters, major complications still occur in ≤ 6% up to 8% of cases. Such major complications have been associated with a 2- to threefold increase in 30-day mortality. Complications specifically involving the aorta, aortic valve annulus, or left ventricle are rare, occurring in only 0.2–1.1% of cases. CASE PRESENTATION: We report the case of a 65-year-old female patient with left ventricular lateral wall perforation during incomplete implantation of a TAVI device, and successive percutaneous completion after surgical repair of the lesion under cardiopulmonary bypass. The surgical strategy and the type of surgical treatment depend on the type of perforation. In general, repair of the lesion and aortic valve replacement are performed. Removal of the TAVI prosthesis and excision of the native aortic valve are standard parts of this repair. CONCLUSION: Here we propose a safe alternative for the completion of the TAVI approach after surgical repair, which requires close coordination between the members of the heart team (anesthesiologist, perfusionist, cardiologist, nurse and cardiac surgeon).
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spelling pubmed-92610752022-07-08 Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair Nasso, Giuseppe Santarpino, Giuseppe Contegiacomo, Gaetano Balducci, Giuseppe Valenzano, Antongiulio Moranti, Enrico Scaringi, Domenico Speziale, Giuseppe Condello, Ignazio J Cardiothorac Surg Case Report BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) continues to grow worldwide. Despite increased operator experience, evolution of the technique, and deflectable catheters, major complications still occur in ≤ 6% up to 8% of cases. Such major complications have been associated with a 2- to threefold increase in 30-day mortality. Complications specifically involving the aorta, aortic valve annulus, or left ventricle are rare, occurring in only 0.2–1.1% of cases. CASE PRESENTATION: We report the case of a 65-year-old female patient with left ventricular lateral wall perforation during incomplete implantation of a TAVI device, and successive percutaneous completion after surgical repair of the lesion under cardiopulmonary bypass. The surgical strategy and the type of surgical treatment depend on the type of perforation. In general, repair of the lesion and aortic valve replacement are performed. Removal of the TAVI prosthesis and excision of the native aortic valve are standard parts of this repair. CONCLUSION: Here we propose a safe alternative for the completion of the TAVI approach after surgical repair, which requires close coordination between the members of the heart team (anesthesiologist, perfusionist, cardiologist, nurse and cardiac surgeon). BioMed Central 2022-07-07 /pmc/articles/PMC9261075/ /pubmed/35794658 http://dx.doi.org/10.1186/s13019-022-01925-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Nasso, Giuseppe
Santarpino, Giuseppe
Contegiacomo, Gaetano
Balducci, Giuseppe
Valenzano, Antongiulio
Moranti, Enrico
Scaringi, Domenico
Speziale, Giuseppe
Condello, Ignazio
Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair
title Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair
title_full Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair
title_fullStr Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair
title_full_unstemmed Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair
title_short Perioperative left ventricular perforation in incomplete TAVI and completion of the procedure after surgical repair
title_sort perioperative left ventricular perforation in incomplete tavi and completion of the procedure after surgical repair
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261075/
https://www.ncbi.nlm.nih.gov/pubmed/35794658
http://dx.doi.org/10.1186/s13019-022-01925-4
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