CTICasesAortic Annulus Rupture during TAVI
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Imaging findings
Pre-TAVI CT shows severe aortic stenosis with bulky calcification of the aortic valve and annulus, extending into the fibrous trigones. Post-TAVI chest x-ray and CT demonstrate high attenuation contrast material outside the aortic root and annulus, with a pericardial drain and new, dramatic pulmonary edema. This indicates rupture of the aortic annulus and formation of an aorto-cardiac fistula.
Key takeaways
Aortic annulus rupture is a rare but severe complication of TAVI, with risk factors including focal bulky annular calcification. Imaging findings can include contrast extravasation from the aortic root, pericardial fluid/drain, and new onset of pulmonary edema, potentially indicating a fistula.
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