PDF(Pubmed)
Abstract：
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has increased in utilization since its approval for management of aortic stenosis patients across all risk strata. We report a rare case of aortic valve leaflet avulsion after balloon expandable TAVR managed with urgent surgery.
METHODS: A 78-year-old male underwent TAVR complicated by avulsion of the native aortic valve leaflet\'s left coronary cusp. He was taken for urgent surgery for cusp resection to prevent thromboembolic complications.
CONCLUSIONS: Native aortic valve leaflet avulsion should be suspected during TAVR in instances of extreme hemodynamic instability after balloon aortic valvuloplasty. As TAVR expands in lower risk patients, surgeons should have a low threshold to intervene surgically to treat native leaflet avulsion or other complications.
METHODS: A 78-year-old male underwent TAVR complicated by avulsion of the native aortic valve leaflet\'s left coronary cusp. He was taken for urgent surgery for cusp resection to prevent thromboembolic complications.
CONCLUSIONS: Native aortic valve leaflet avulsion should be suspected during TAVR in instances of extreme hemodynamic instability after balloon aortic valvuloplasty. As TAVR expands in lower risk patients, surgeons should have a low threshold to intervene surgically to treat native leaflet avulsion or other complications.
摘要：
背景：经导管主动脉瓣置换术（TAVR）自批准用于所有风险层的主动脉瓣狭窄患者的管理以来，其使用率一直在增加。我们报告了一例罕见的主动脉瓣小叶撕脱症病例，经紧急手术治疗后进行了球囊扩张TAVR。
方法：一名78岁的男性接受了TAVR，并伴有自体主动脉瓣小叶的左冠状动脉尖撕脱。他被送往紧急手术切除，以防止血栓栓塞并发症。
结论：在TAVR过程中，在球囊主动脉瓣成形术后血流动力学极度不稳定的情况下，应怀疑自体主动脉瓣叶撕脱。随着TAVR在低风险患者中的扩展，外科医生应具有较低的手术干预阈值，以治疗天然小叶撕脱或其他并发症。
方法：一名78岁的男性接受了TAVR，并伴有自体主动脉瓣小叶的左冠状动脉尖撕脱。他被送往紧急手术切除，以防止血栓栓塞并发症。
结论：在TAVR过程中，在球囊主动脉瓣成形术后血流动力学极度不稳定的情况下，应怀疑自体主动脉瓣叶撕脱。随着TAVR在低风险患者中的扩展，外科医生应具有较低的手术干预阈值，以治疗天然小叶撕脱或其他并发症。
