Transapical Aortic Valve Implantation in 194 Patients: Problems, Complications, and Solutions

Prosthesis Oversizing in Balloon-Expandable Transcatheter Aortic Valve Implantation Is Associated With Contained Rupture of the Aortic Root

“…8,13,15,24 In theory, both entities may belong to the spectrum of the same pathology, namely disruption of the aortoventricular junction, caused by either the forces of the preceding valvuloplasty or the actual TAVI procedure. In the study presented, we found 3 cases of contained rupture of the aortic root by means of MSCT.…”

“…[10][11][12] With the introduction of TAVI, performing physicians and surgeons may encounter incidents and complications different from those in conventional aortic valve surgery, such as annulus or aortic root rupture and pseudoaneurysm formation of the aortic root. 8,[13][14][15] These complications may be evident while performing the procedure or may be apparent at followup studies. However, data are limited and risk factors for these entities have not been investigated thoroughly yet.…”

“…5 Incorrect sizing may result in adverse outcomes such as paravalvular regurgitation, device embolization, 6,7 or even aortic root rupture in the case of severe oversizing. 8 Although there is no uniform standard for prosthesis sizing with dissenting results among different image modalities, MSCT is increasingly used because of its capability of 3-dimensional assessment of the complex aortic root anatomy. 9 Recent studies suggest that MSCT might be more suitable to assess the aortic annulus size than 2-dimensional echocardiography.…”

Transaortic transcatheter aortic valve implantation: Results of the Polish arm of the ROUTE registry

“…Alternatively, a transapical approach (TA-TAVI) can be employed [6]. Still, this route has certain limitations; it is not recommended in patients with chronic lung diseases or poor left ventricular function, and is associated with a risk of serious bleeding complications [7][8][9]. The use of transaortic (TAo) access is a more recently developed alternative to TA-TAVI and TF-TAVI [10,11].…”

Thirty-Day Outcome of Transcatheter Aortic Valve Implantation With the Edwards SAPIEN XT Prosthesis via the Transiliofemoral Approach

“…15 Moreover, small aortic annulus size carries a potential risk of annulus rupture due to the risk of oversized valve prosthesis. 17, 18 Therefore, correct sizing of the annulus and appropriate choice of the valve is crucial. Recent studies have shown that CT-guided annular sizing resulted in a smaller number of patients with aortic regurgitation grade worse than mild after TAVI.…”