title: Successful repair of aortic annulus rupture during transcatheter aortic valve replacement using extracorporeal membrane oxygenation support.
abstract: Aortic annular rupture is a rare and much dreaded complication of transcatheter aortic valve replacement. Device oversizing to prevent post-procedural paravalvular leak is the most commonly identified cause of this complication. However, mechanical stress in a heavily calcified non-compliant vessel can also lead to annular rupture in this older population. We describe a case of aortic annular rupture with involvement of right coronary artery ostium leading to cardiac tamponade and cardiac arrest, successfully managed by extracorporeal membrane oxygenation support, open drainage of the pericardial space, pericardial patching of the defect and bypass of the affected vessel with excellent post-procedural results.
authors.affiliation: Center for Advanced Heart Failure, University of Texas at Houston, 6410 Fannin Street, Suite # 370, Houston, TX, 77030, USA, smita.i.negi@uth.tmc.edu.
authors.forename: Smita I
authors.initials: SI
authors.lastname: Negi
authors.forename: Jay
authors.initials: J
authors.lastname: Patel
authors.forename: Manish
authors.initials: M
authors.lastname: Patel
authors.forename: Pranav
authors.initials: P
authors.lastname: Loyalka
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: Igor
authors.initials: I
authors.lastname: Gregoric
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000293:injuries* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D002305:Cardiac Tamponade / Q000209:etiology / Q000601:surgery; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000209:etiology; D006341:Heart Rupture / Q000209:etiology* / Q000601:surgery; D006801:Humans; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*