This article is part of CTSNet’s series, Perfecting TAVR Removal | Skills Sharpening With Vince Gaudiani. [3] CTSNet Senior Editor Dr. Vince Gaudiani presents nine surgical videos on the technical aspects of aortic valve replacement after TAVR. This series will conclude in three live learning roundtable events, scheduled at three different times to accommodate participants in multiple regions of the world. 

In this video, the patient underwent transcatheter aortic valve replacement (TAVR), during which a pericardial collection was identified. The patient was initially stable, but after two days and further imaging, a contained aortic annulus rupture was diagnosed, and he was urgently taken to the operating room.   

The removal of the new TAVR was relatively straightforward, utilizing the handlebar mustache technique, scissors, and a wire cutter.  The annulus was debrided, and the aortic rupture was found under the left main stem.   

A Dacron patch was placed over the defect, followed by pledgeted 2-0 sutures for the 25 mm valve over the patch, and the operation was completed.  

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