title: Factor VIIa for Annulus Rupture After Transcatheter Aortic Valve Replacement.
abstract: Over the last decade, transcatheter aortic valve replacement (TAVR) has emerged as an effective treatment for inoperable and selected high surgical-risk patients with aortic stenosis. However, management of procedural complications with TAVR represents a major challenge as most TAVR patients carry prohibitive or high-risk of mortality with open surgical conversion. Here we present a case of TAVR complicated by aortic annulus rupture that was successfully managed nonoperatively by pericardial drainage, blood product transfusion, and adjunctive administration of recombinant activated factor VIIa.
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Keenan
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: John P
authors.initials: JP
authors.lastname: Vavalle
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Asvin M
authors.initials: AM
authors.lastname: Ganapathi
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Hanghang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Harrison
authors.affiliation: Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
authors.forename: Andrew
authors.initials: A
authors.lastname: Wang
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: gchad.hughes@duke.edu.
authors.forename: G Chad
authors.initials: GC
authors.lastname: Hughes
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000293:injuries*; D015942:Factor VIIa / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011994:Recombinant Proteins / Q000627:therapeutic use; D012421:Rupture / Q000188:drug therapy; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
chemical_list: D011994:Recombinant Proteins; C103587:recombinant FVIIa; D015942:Factor VIIa