Rare device landing zone ruptures after transcatheter aortic valve implantation (TAVI)

Abstract

Rupture of the “device landing zone” is a rare but severe complication of transcatheter aortic valve implantation (TAVI). Recently, the small segment of muscular left ventricular outflow tract (LVOT) located between the left–right commissure and left fibrous trigone was identified as the most vulnerable region at risk of external rupture. We here provide the first pictures of a rupture adjacent to this vulnerable area, inducing a connection between the LVOT and the left atrium. We also report a case of supra-annular rupture, a less usual location of rupture. These illustrations may help pathologists and clinicians to get familiar with early rare complications of TAVI, an important new field of interest of autopsy in cardiovascular pathology.