title: Unexpected left ventricular free-wall rupture following an aortic catheter-valve implantation.
abstract: Our experience with the Sapien trans-apical aortic valve (Edwards Lifesciences Inc., Irvine, CA, USA) has been straightforward without per-procedural mortality except in 1/16 consecutive cases who developed non-apical haemorrhage early after valve implantation. We describe the case of an 84-year-old female carrying a very high operative risk (logistic EuroScore of 44%), who underwent a trans-apical stent-valve implantation for severe and symptomatic aortic valve stenosis (23 mm). Due to massive blood loss, an emergency sternotomy and cannulation for cardiopulmonary bypass resuscitation were necessary to treat (without success) an unusual and unexpected subaortic left ventricular free-wall rupture that occurred few minutes after the stent-valve positioning and implantation. To the best of our knowledge, this is the first described case of a left ventricular free-wall rupture occurring after an otherwise non-complicated standard catheter-based aortic valve replacement.
authors.affiliation: Department of Cardio-Vascular Surgery, University Hospital of Lausanne (CHUV), Lausanne, Switzerland. enricoferrari@bluewin.ch
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrari
authors.forename: Elena
authors.initials: E
authors.lastname: Rizzo
authors.forename: Christopher
authors.initials: C
authors.lastname: Sulzer
authors.forename: Ludwig Karl
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000601:surgery*; D016063:Blood Loss, Surgical; D005260:Female; D006341:Heart Rupture / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans