Aortic Dissection Following Transcatheter Aortic Valve Replacement.

Abstract

Transcatheter Aortic Valve Replacement (TAVR) continues to grow in popularity and has become the preferred mechanism for the treatment of aortic stenosis in most patients. Despite significant improvements in the safety of TAVR, complications remain inevitable. Aortic dissection, although rare, is a feared complication following TAVR. Aortic dissection after TAVR has been reported to occur in both the ascending and descending thoracic aorta and may occur acutely during valve placement or in a delayed fashion. Bicuspid aortic valve and ascending aortic aneurysm may increase the risk for Type A dissection following TAVR. Given the rarity of aortic dissection in TAVR, a high index of suspicion must be maintained to provide prompt diagnosis and management. Open surgical repair is the preferred treatment modality for type A aortic dissection, however endovascular management and conservative medical therapy can be utilized in select patients and are more commonly employed for type B dissection.