A very rare vascular complication of the Edwards expandable eSheath during transcatheter aortic valve replacement
Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe symptomatic aortic valve stenosis. TAVR is now indicated as an alternative to surgical replacement in a wide risk profile ranging from high to low surgical risk. Although vascular complications have decreased i...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2023-02, Vol.101 (3), p.660-667 |
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| creator | Savvoulidis, Panagiotis Nadir, Adnan M. Mechery, Anthony Doshi, Sagar N. |
| description | Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe symptomatic aortic valve stenosis. TAVR is now indicated as an alternative to surgical replacement in a wide risk profile ranging from high to low surgical risk. Although vascular complications have decreased in frequency over time, with the introduction of lower profile delivery systems and sheaths, they remain one of the most frequently encountered and serious complications of TAVR. Patient‐specific predisposing factors have been well characterized. However, much less is known about device‐specific complications. Awareness of the possible device‐related complications may lead to earlier identification, prompt management, and better outcomes. We report a previously unreported complication of the Edwards expandable eSheath that lead to avulsion of the external iliac artery following successful TAVR with a 29‐mm Edwards Sapien 3 transcatheter heart valve. Bleeding was promptly controlled with an occlusion balloon and emergency surgical repair was required with a favorable outcome. |
| doi_str_mv | 10.1002/ccd.30557 |
| format | Article |
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TAVR is now indicated as an alternative to surgical replacement in a wide risk profile ranging from high to low surgical risk. Although vascular complications have decreased in frequency over time, with the introduction of lower profile delivery systems and sheaths, they remain one of the most frequently encountered and serious complications of TAVR. Patient‐specific predisposing factors have been well characterized. However, much less is known about device‐specific complications. Awareness of the possible device‐related complications may lead to earlier identification, prompt management, and better outcomes. We report a previously unreported complication of the Edwards expandable eSheath that lead to avulsion of the external iliac artery following successful TAVR with a 29‐mm Edwards Sapien 3 transcatheter heart valve. 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TAVR is now indicated as an alternative to surgical replacement in a wide risk profile ranging from high to low surgical risk. Although vascular complications have decreased in frequency over time, with the introduction of lower profile delivery systems and sheaths, they remain one of the most frequently encountered and serious complications of TAVR. Patient‐specific predisposing factors have been well characterized. However, much less is known about device‐specific complications. Awareness of the possible device‐related complications may lead to earlier identification, prompt management, and better outcomes. We report a previously unreported complication of the Edwards expandable eSheath that lead to avulsion of the external iliac artery following successful TAVR with a 29‐mm Edwards Sapien 3 transcatheter heart valve. 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| issn | 1522-1946 1522-726X |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aortic valve Aortic Valve - diagnostic imaging Aortic Valve - surgery Aortic Valve Stenosis - diagnostic imaging Aortic Valve Stenosis - surgery avulsion Balloon treatment Heart Valve Prosthesis Humans Prosthesis Design self‐expanding sheaths Sheaths Stenosis transcatheter aortic valve implantation Transcatheter Aortic Valve Replacement - adverse effects Treatment Outcome vascular complication |
| title | A very rare vascular complication of the Edwards expandable eSheath during transcatheter aortic valve replacement |
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