TY - JOUR
AU1 - Chietera, Francesco
AU2 - Saia, Francesco
AU3 - Palmerini, Tullio
AB - A 65-year-old male truck driver was admitted to the emergency department after a road crush with consequent polytrauma. Patient’s past medical and cardiovascular history were unremarkable. Physical examination showed neck haematoma with multiple contusions, abolished right vesicular murmur, bone deformities. Whole-body CT scan documented multiple bone fractures, right hemothorax and pneumothorax, mediastinal haematoma, bilateral pulmonary contusions and rib fractures, dissection not limiting flow of right subclavian artery, left vertebral artery and both internal carotid arteries with associated pseudoaneurysms. Emergency chest drainage was performed and the patient was intubated because of worsening dyspnoea. Transthoracic echocardiography documented massive aortic insufficiency due to cusp rupture (Panels A and B and Supplementary material online, Videos S1 and S2) in the context of aortic bicuspidia (Sievers Type 1) and pulmonary hypertension with signs of right ventricular dysfunction. Because of patient’s extremely critical condition with hemodynamic instability and pulmonary congestion and concomitant prohibitive surgical risk for urgent aortic valve replacement, off-label transcatheter aortic valve replacement was planned. Open in new tabDownload slide Pre-TAVI CT angiography is shown in Panels C and D. The aortic annulus had an area of 507 mm2, a perimeter of 83 mm, and no calcium was apparent in the aortic root. The raphe was between the right and left coronary cusps. Although the annulus dimension would have required a balloon-expandable Sapien Ultra 26 mm, a transfemoral Sapien 29 mm (28% oversizing) was eventually implanted with optimal final result, no residual perivalvular leak, and no other peri-procedural complications (Panel E and Supplementary material online, Videos S3–S7). Supplementary material is available at European Heart Journal online. F.S. is a consultant for Abbott, Edwards Lifesciences and Medtronic and received lecture's fees from Abbott, Edwards Lifesciences, and Medtronic. T.P. received honorary from Edwards Lifesciences and consulting fees from Medtronic. The data underlying this article are available in the article and in its online Supplementary material. All authors declare no funding for this contribution. © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
TI - Post-traumatic acute aortic regurgitation due to cusp rupture in non-calcific bicuspid valve treated with ballon-expandable transcatheter heart valve
JF - European Heart Journal
DO - 10.1093/eurheartj/ehac805
DA - 2023-01-12
UR - https://www.deepdyve.com/lp/oxford-university-press/post-traumatic-acute-aortic-regurgitation-due-to-cusp-rupture-in-non-0LEDD0l0VK
SP - 1002
EP - 1002
VL - 44
IS - 11
DP - DeepDyve
ER -