3D modeling reveals cause of balloon rupture during TAVR in patients with bicuspid aortic valves

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Announcing a new article publication for Cardiovascular Innovations and Applications journal. Balloon rupture during transcatheter aortic valve replacement (TAVR) is a rare but serious complication.

The authors of this article present two cases of balloon rupture in patients with severe aortic stenosis and type 0 bicuspid aortic valves. Three-dimensional models based on pre-procedure cardiac CT angiography were used to investigate these cases post hoc. The models revealed asymmetrical distribution of calcifications with sharply spiked features in the bicuspid aortic valves. The narrow calcified orifices resulted in uneven force distribution on the expanded balloon, thus leading to balloon rupture. Additionally, the classification and causes of balloon rupture are reviewed, methods for avoiding complications are summarized, and treatment options are described.

Accurate pre-procedural anatomy evaluation and computer modeling are crucial for planning and managing TAVR procedures. Further investigation through computer simulation is necessary to determine the appropriate balloon size and inflation locations, to provide a reference for pre-procedural preparation.

Journal reference:

Wu, X., et al. (2023) Balloon Rupture during Pre-Dilation for Transcatheter Aortic Valve Replacement in Patients with a Bicuspid Aortic Valve: Classification, Treatment Strategies, and Prevention. Cardiovascular Innovations and Applications. doi.org/10.15212/CVIA.2023.0063.


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