Aorto-Right Ventricular Fistula Post-Transcatheter Aortic Valve Replacement: Multimodality Imaging of Successful Percutaneous Closure

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Aorto-right ventricular fistula is a rare diagnosis and is on the spectrum of aortic periannular rupture.
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Multimodality imaging is crucial in identifying aortic periannular rupture, defining its course, and for preprocedural planning.
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We describe a case of aorto-right ventricular fistula, which was successfully treated using an Amplazter vascular plug intravenous device (St. Jude Medical) and is to our knowledge the first reported case of using a plugging device for this type of disorder.

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Development and Validation of a Risk Prediction Model for In-Hospital Mortality After Transcatheter Aortic Valve Replacement.

Fred H Edwards, David J. Cohen, Sean M O'Brien … (2016)

Patient selection for transcatheter aortic valve replacement (TAVR) should include assessment of the risks of TAVR compared with surgical aortic valve replacement (SAVR). Existing SAVR risk models accurately predict the risks for the population undergoing SAVR, but comparable models to predict risk for patients undergoing TAVR are currently not available and should be derived from a population that underwent TAVR.

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Annular rupture during transcatheter aortic valve replacement: classification, pathophysiology, diagnostics, treatment approaches, and prevention.

Miralem Pasic, Axel Unbehaun, Semih Buz … (2015)

Annular rupture is an umbrella term covering different procedural-related injuries that may occur in the region of the aortic root and the left ventricular outflow tract during transcatheter aortic valve replacement. According to the anatomical location of the injury, there are 4 main types: supra-annular, intra-annular, subannular, and combined rupture. Annular rupture is a rare, unpredictable, and potentially fatal complication. It can be treated successfully if it is immediately recognized and adequately managed. The type of therapy depends on the location of the annular rupture and the nature of the clinical manifestations. Treatment approaches include conventional cardiac procedure, isolated pericardial drainage, and conservative therapy. This summary describes theoretical and practical considerations of the etiology, pathophysiology, classification, natural history, diagnostic and treatment strategies, and prevention approaches of annular rupture.

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Transcatheter Aortic Valve Replacement 2016: A Modern-Day "Through the Looking-Glass" Adventure.

Torsten P Vahl, Susheel Kodali, Martin Leon (2016)

Transcatheter aortic valve replacement (TAVR) has become a safe and effective therapy for patients with severe aortic stenosis (AS). In recent trials, the hemodynamic performance and clinical outcomes of the latest generation of TAVR devices demonstrated at least parity with surgical outcomes in patients of similar risk. Many initial obstacles with TAVR have largely been overcome, including frequent access site complications and concerns about strokes and paravalvular leaks. Using a multidisciplinary heart team approach, patient selection, procedural planning, and device implantation have been refined and optimized such that clinical outcomes are generally predictable and reproducible. Future research will focus on the durability of TAVR devices, further enhancements in clinical outcomes, and adjunctive therapies. On the basis of initial results from ongoing clinical trials, the indication for TAVR will likely expand to lower-risk patients. This review provides an overview of recent progress in this field, and highlights future opportunities and directions.

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Author and article information

Journal

Journal ID (nlm-ta): CASE (Phila)

Journal ID (iso-abbrev): CASE (Phila)

Title: CASE : Cardiovascular Imaging Case Reports

Publisher: Elsevier

ISSN (Electronic): 2468-6441

Publication date PMC-release: 24 April 2017

Publication date Collection: April 2017

Publication date (Electronic): 24 April 2017

Volume: 1

Issue: 2

Pages: 70-74

Affiliations

[a ]Leon H. Charney Division of Cardiology, New York University Langone Medical Center, New York, New York

[b ]Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York

[c ]Department of Radiology, New York University Langone Medical Center, New York, New York

Article

Publisher ID: S2468-6441(16)30029-9

DOI: 10.1016/j.case.2017.02.002

PMC ID: 6034486

PubMed ID: 30062248

SO-VID: 66e2b076-376b-4f53-abc0-e59d9fd08b05

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Aorto-Right Ventricular Fistula Post-Transcatheter Aortic Valve Replacement: Multimodality Imaging of Successful Percutaneous Closure

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Most cited references 6

Development and Validation of a Risk Prediction Model for In-Hospital Mortality After Transcatheter Aortic Valve Replacement.

Annular rupture during transcatheter aortic valve replacement: classification, pathophysiology, diagnostics, treatment approaches, and prevention.

Transcatheter Aortic Valve Replacement 2016: A Modern-Day "Through the Looking-Glass" Adventure.

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