CTICasesTAVI-Related Aortic Root Rupture with Right AV Groove Hematoma
Imaging findings
CT demonstrates a hematoma tracking along the entire course of the right coronary artery within the right atrioventricular groove following TAVI, deep to the pericardium within the epicardial fat. The hematoma fills the AV groove and follows the right coronary artery territory, with stranding of the epicardial fat. This pattern is related to rupture of the aortic root at the TAVI site with blood dissecting into the epicardial fat and following the AV groove along the RCA.
Key takeaways
TAVI-related aortic root complications can result in blood tracking into the epicardial fat along the right atrioventricular groove, producing a hematoma that follows the course of the right coronary artery. This is an additional case confirming the pattern of AV groove hematoma seen in aortic dissection, and demonstrates that the same anatomical pathway can be involved in TAVI complications. Recognition of this pattern on post-procedural CT is important for guiding surgical management.
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