Potential mechanism of annulus rupture during transcatheter aortic valve implantation

Kentaro Hayashida, Erik Bouvier, Thierry Lefèvre, Thomas Hovasse, Marie Claude Morice, Bernard Chevalier, Mauro Romano, Philippe Garot, Arnaud Farge, Patrick Donzeau-Gouge, Bertrand Cormier

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71 Citations (Scopus)


Although annulus rupture is one of the most severe complications of transcatheter aortic valve implantation (TAVI), the incidence and mechanism of this complication remain unclear. Out of 387 consecutive TAVI cases in our institution, the incidence of annulus rupture was 1.0% (4/387). The first two patients died because of hemodynamic collapse due to tamponade on day 0. Both surviving patients had undergone preprocedural multidetector computed tomography which revealed large calcifications in the epicardial fat part of the aortic annulus. In both cases, annulus rupture occurred after deployment of a balloon expandable valve suggesting that mechanical compression of this "vulnerable area" by calcification may cause annulus rupture.

Original languageEnglish
Pages (from-to)E742-E746
JournalCatheterization and Cardiovascular Interventions
Issue number5
Publication statusPublished - 2013 Nov 1
Externally publishedYes


  • annular geometry
  • aortic stenosis
  • cardiac tamponade
  • computed tomography
  • transcatheter aortic valve

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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