Vannini L, Andrea R, Sabaté M. Conservative management of aortic root rupture complicated with cardiac tamponade following transcatheter aortic valve implantation. World J Cardiol 2017; 9(4): 391-395 [PMID: 28515859 DOI: 10.4330/wjc.v9.i4.391]
Corresponding Author of This Article
Rut Andrea, MD, PhD, Department of Cardiology, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, Spain. randrea@clinic.ub.es
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Apr 26, 2017; 9(4): 391-395 Published online Apr 26, 2017. doi: 10.4330/wjc.v9.i4.391
Conservative management of aortic root rupture complicated with cardiac tamponade following transcatheter aortic valve implantation
Luca Vannini, Rut Andrea, Manel Sabaté
Luca Vannini, Rut Andrea, Manel Sabaté, Department of Cardiology, Hospital Clínic, 08036 Barcelona, Spain
Author contributions: All the authors contributed to the redaction of this manuscript.
Institutional review board statement: Since this is not a study but just a case report, there is no institutional review board statement.
Informed consent statement: The patients involved in this study gave their written informed consent.
Conflict-of-interest statement: The authors do not have conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rut Andrea, MD, PhD, Department of Cardiology, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, Spain. randrea@clinic.ub.es
Telephone: +34-93-2279305 Fax: +34-93-2279305
Received: July 11, 2016 Peer-review started: July 11, 2016 First decision: September 2, 2016 Revised: October 18, 2016 Accepted: December 16, 2016 Article in press: December 19, 2016 Published online: April 26, 2017 Processing time: 291 Days and 7.6 Hours
Abstract
Aortic root rupture and cardiac tamponade during transcatheter aortic valve implantation is a frightening complication with high mortality rate. A conservative management of this complication could represent an initial strategy, especially in high-risk patients, to avoid emergent cardiac surgery. This conservative management includes: Immediate detection of pericardial effusion by echocardiography, a fast instauration of pericardial drainage, auto-transfusion and anticoagulation reversal. We describe two cases of patients who suffered this complication and were treated successfully with this initial approach.
Core tip: Aortic root rupture during transcatheter aortic valve implantation is a rare but severe complication with high mortality rate. We described two cases of aortic root rupture where we realized a conservative management with rapid anticoagulation reversal and pericardial drainage with blood auto-transfusion. These cases highlight the utility of rapid identification of aortic root hematoma and pericardial effusion by transesophageal echocardiography. Immediate detection of this complication allows to stabilize the patient avoiding further urgent interventions.
