Abstract
Transcatheter balloon aortic valvuloplasty (TBAV) is an effective primary approach for severe aortic valve stenosis in pediatric patients. The complications of this procedure include vascular access problems, aortic regurgitation, arrhythmia, residual stenosis, and death. Aortic wall tear with the formation of intimal flaps as a consequence of this procedure is underdiagnosed and underreported. We report a case series of 4 patients diagnosed with aortic wall tear out of 49 patients with severe aortic stenosis who underwent TBAV below the age of 4 months from 2007 to 2017 as a single-center retrospective experience. Two patients had significant aortic wall injury with the formation of multiple intimal flaps, resulting in substantially reduced ventricular function and death. Aortic wall injury is a rare complication after TBAV and is still under-recognized even in the current era. It is more associated with critical aortic stenosis and severely decreased ventricular function, specifically in neonatal age. If the injury involves the transverse arch with multiple intimal flaps, the risk of mortality becomes high.
•TBAV is an effective primary approach for severe aortic valve stenosis in pediatrics.•Aortic wall injury is a rare complication after TBAV and is still under-recognized.•We report 4 cases with aortic wall tear below the age of 4 months following TBAV.•It is associated with critical AS and severely decreased VF, specifically in neonates.•The risk of mortality becomes high if the injury involves the transverse arch.