Jeffrey E. Keenan, MD, John P. Vavalle, MD, Asvin M

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Presentation transcript:

Factor VIIa for Annulus Rupture After Transcatheter Aortic Valve Replacement Jeffrey E. Keenan, MD, John P. Vavalle, MD, Asvin M. Ganapathi, MD, Hanghang Wang, MD, J. Kevin Harrison, MD, Andrew Wang, MD, G. Chad Hughes, MD The Annals of Thoracic Surgery Volume 100, Issue 1, Pages 313-315 (July 2015) DOI: 10.1016/j.athoracsur.2014.09.063 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Reformatted three-dimensional computed tomographic angiography image demonstrating severe confluent calcification of the aortic and mitral valve annuli, anatomy which likely predisposes to the complication of annular rupture with aggressive balloon inflation in the aortic annulus. The Annals of Thoracic Surgery 2015 100, 313-315DOI: (10.1016/j.athoracsur.2014.09.063) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) and (B) Balloon aortic valvuloplasty with simultaneous root angiogram immediately prior to transcatheter aortic valve replacement. (C) Deployment of transcatheter valve. (D) Completion root angiogram. The Annals of Thoracic Surgery 2015 100, 313-315DOI: (10.1016/j.athoracsur.2014.09.063) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Intraoperative transesophageal echocardiography. (A) and (B) Long and short-axis views, respectively, of aortic root prior to transcatheter aortic valve replacement (TAVR). (C) and (D) Long and short-axis views, respectively, of the aortic root after TAVR with edema and new fluid around the aortic root (white arrows), a diagnostic feature of annular rupture. (AV = aortic valve; LA = left atrium; LV = left ventricle; LVOT - left ventricular outflow tract; RA = right atrium.) The Annals of Thoracic Surgery 2015 100, 313-315DOI: (10.1016/j.athoracsur.2014.09.063) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions