Anatomical and procedural features associated with aortic root rupture during balloon-expandable transcatheter aortic valve replacement

  • Barbanti M
  • Yang T
  • Rodès Cabau J
 et al. 
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BACKGROUND: Aortic root rupture is a major concern with balloon-expandable transcatheter aortic valve replacement (TAVR). We sought to identify predictors of aortic root rupture during balloon-expandable TAVR by using multidetector computed tomography. METHODS AND RESULTS: Thirty-one consecutive patients who experienced left ventricular outflow tract (LVOT)/annular/aortic contained/noncontained rupture during TAVR were collected from 16 centers. A caliper-matched sample of 31 consecutive patients without annular rupture, who underwent pre-TAVR multidetector computed tomography served as a control group. Multidetector computed tomography assessment included short- and long-axis diameters and cross-sectional area of the sinotubular junction, annulus, and LVOT, and the presence, location, and extent of calcification of the LVOT, as well. There were no significant differences between the 2 groups in any preoperative clinical and echocardiographic variables. Aortic root rupture was identified in 20 patients and periaortic hematoma in 11. Patients with root rupture had a higher degree of subannular/LVOT calcification quantified by the Agatston score (181.2±211.0 versus 22.5±37.6, P

Author-supplied keywords

  • Annular calcification
  • Annular rupture
  • Multidetector computed tomography
  • Transcatheter heart valves

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  • Marco Barbanti

  • Tae Hyun Yang

  • Josep Rodès Cabau

  • Corrado Tamburino

  • David A. Wood

  • Hasan Jilaihawi

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