{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T07:13:32Z","timestamp":1760080412144,"version":"3.37.3"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Aortic root rupture is a severe complication of balloon-expandable transcatheter aortic valve replacement (TAVR). Although previous studies have revealed several risk factors for this complication, predicting this complication is occasionally difficult.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 78-year-old male patient underwent TAVR via a transfemoral approach using a 29-mm balloon-expandable valve. No recognized risk factors for aortic root rupture existed in pre-procedural multi-detector computed tomography (MDCT) analysis. However, after the valve deployment, sudden haemodynamic collapse occurred. Transoesophageal echocardiography revealed pericardial effusion, which led to an immediate diagnosis of cardiac tamponade following aortic root rupture. Following pericardial drainage via a subxiphoid approach, the haemodynamics were immediately stabilized. After 10\u2009days of close observation, the patient was discharged on Day 39 without additional problems. He was still alive at the 6-month follow-up without sequelae.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Established risk factors for aortic root rupture include &amp;gt;20% area oversizing, bicuspid aortic valve, small annulus (&amp;lt;20\u2009mm), shallow sinus of Valsalva (SOV) compared with the aortic annulus, and massive annular or subannular calcification. Our patient did not have any of the recognized risk factors for aortic root rupture, suggesting the existence of other factors. Pre-procedural MDCT showed a flat calcification orthogonal to the aortic root wall, and post-procedural MDCT revealed that this calcification penetrated the SOV with extravasation. Thus, we suggest that a flat calcification orthogonal to the aortic root wall might be an additional risk factor for aortic root rupture.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa073","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T02:20:14Z","timestamp":1590546014000},"page":"1-4","source":"Crossref","is-referenced-by-count":4,"title":["Aortic root rupture during balloon-expandable transcatheter aortic valve replacement in a patient without recognized risk factors for aortic root rupture: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-7047","authenticated-orcid":false,"given":"Masaki","family":"Tsuda","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita 565-0871, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isamu","family":"Mizote","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita 565-0871, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Mukai","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita 565-0871, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Sakata","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita 565-0871, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,5,26]]},"reference":[{"key":"2020062620244308400_ytaa073-B1","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1161\/CIRCINTERVENTIONS.111.967315","article-title":"Rupture of the device landing zone during transcatheter aortic valve implantation: a life-threatening but treatable complication","volume":"5","author":"Pasic","year":"2012","journal-title":"Circ Cardiovasc Interv"},{"key":"2020062620244308400_ytaa073-B2","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1161\/CIRCULATIONAHA.113.002947","article-title":"Anatomical and procedural features associated with aortic root rupture during balloon-expandable transcatheter aortic valve replacement","volume":"128","author":"Barbanti","year":"2013","journal-title":"Circulation"},{"key":"2020062620244308400_ytaa073-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcin.2014.07.020","article-title":"Annular rupture during transcatheter aortic valve replacement: classification, pathophysiology, diagnostics, treatment approaches, and prevention","volume":"8","author":"Pasic","year":"2015","journal-title":"JACC Cardiovasc Interv"},{"key":"2020062620244308400_ytaa073-B4","doi-asserted-by":"crossref","first-page":"94","DOI":"10.15420\/icr.2015.10.2.94","article-title":"Avoiding coronary occlusion and root rupture in TAVI\u2014the role of pre-procedural imaging and prosthesis selection","volume":"10","author":"Barbanti","year":"2015","journal-title":"Interv Cardiol (Lond)"},{"key":"2020062620244308400_ytaa073-B5","doi-asserted-by":"crossref","first-page":"E742","DOI":"10.1002\/ccd.24524","article-title":"Potential mechanism of annulus rupture during transcatheter aortic valve implantation","volume":"82","author":"Hayashida","year":"2013","journal-title":"Cathet Cardiovasc Intervent"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/3\/1\/33434338\/ytaa073.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/3\/1\/33434338\/ytaa073.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T08:09:03Z","timestamp":1593245343000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/3\/1\/5846246"}},"subtitle":[],"editor":[{"given":"Georg","family":"Goliasch","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Christoph","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Erik","family":"Holy","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Stefan","family":"Simovic","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Peysh A","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,5,26]]},"references-count":5,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,5,26]]},"published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa073","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2020,6]]},"published":{"date-parts":[[2020,5,26]]}}}