Abstract
BACKGROUND: Over the past 2 decades, transcatheter aortic valve replacement (TAVR) has emerged as a widely accepted treatment for patients with severe aortic valve stenosis. Acute aortic dissection, although rare, is a life-threatening complication associated with TAVR. CASE SUMMARY: An older man with severe aortic stenosis underwent TAVR. During valve deployment, catheter manipulation caused intimal disruption, leading to acute type A aortic dissection (TAAD). Remarkably, the dissection spontaneously sealed after prosthetic valve placement, thereby avoiding emergency surgery. A 6-month follow-up computed tomography angiography scan showed no extension of the dissection. DISCUSSION: In the case we report, the dissection spontaneously sealed with the use of a prosthetic valve, a finding that reinforces the feasibility of nonsurgical management of iatrogenic TAAD during TAVR in select cases. TAKE-HOME MESSAGE: The use of a biological valve offers a novel perspective on the conservative management of iatrogenic aortic dissection in high-risk patients during TAVR.