Perforation of the Descending Thoracic Aorta During Transcatheter Aortic Valve Implantation (TAVI): An Unexpected and Dramatic Procedural Complication

Transcatheter aortic valve implantation (TAVI) has become an established technique for the treatment of aortic stenosis in patients who cannot undergo surgery. Although TAVI is obviously less invasive than open surgical repair, it is not free of complications. We report a case of unexplained refractory shock during transfemoral TAVI with subsequent autopsy demonstrating a 1-cm large perforation of the descending thoracic aorta as the cause of death. To the best of our knowledge, this is the first case ever reported. (C) 2011 Wiley-Liss, Inc.