Delayed Mortality from Aortic Dissection Post Transcatheter Aortic Valve Implantation (TAVI): the Tip of the Iceberg

We report two cases of autopsy confirmed aortic dissection as a cause of death following trans aortic valve implantation (TAVI). The TAVI procedures were performed via the transapical and transfemoral route, respectively, and death occurred several days after the index procedure and not immediately. This highlights a potential cause of delayed unexplained death days post TAVI and may be overlooked as a potential cause of death in patients undergoing this procedure. This also questions the empirical use of dual antiplatelet therapy following TAVI which could potentially exacerbate this phenomenon. (C) 2010 Wiley-Liss, Inc.