Complications, Volume 1, Issue 2 (September 2024) – 2 articles

Percutaneous aortic valve replacement (TAVI) has become the treatment of choice for elderly patients with severe aortic valve stenosis because of its less invasive nature compared to surgery. As TAVI is increasingly offered, issues such as vascular lesions, access site problems, paravalvular leaks, and aortic dissection (AD) are a few associated complications, needing consideration. AD after TAVI is rare but serious, occurring in 0.2% to 0.3% of cases, with both intraprocedural and late cases reported. This case study concerns a 68-year-old woman who developed Stanford B AD, external iliac artery dissection, and right common femoral artery occlusion after TAVI. Treatment included the stenting of the iliac and common femoral arteries, followed by a staged procedure: debranching, thoracic endovascular aortic repair (TEVAR), and endovascular aneurysm repair (EVAR), with satisfactory results. This case underscores the importance of vigilance in the management of TAVI-related complications to optimize patient care and outcomes. Full article

Background: Intestinal intussusception is defined as the invagination of one segment of the intestine into the lumen of an adjacent intestinal segment, resulting in the mechanical intestinal obstruction of multifactorial origin with a high risk of morbidity and mortality. It is a rare pathology in adults with a nonspecific clinical presentation. We present the case of a 26-year-old male patient who was admitted postoperatively after multiple extra institutional surgical interventions due to polytrauma secondary to a work-related accident that caused high-impact trauma by a solids mixer. However, he was referred to our institution due to suspected vascular trauma in the right femoral artery. During his hospital stay, he developed intolerance to oral intake associated with pain, abdominal distension, and persistent emetic episodes despite medical management. Consequently, an abdominal CT scan with double contrast was requested, revealing intestinal intussusception secondary to intestinal adhesions, which required new surgical management with a favorable resolution; Discussion: Intussusception in the adult population is rare and is primarily caused by an identifiable structural lesion. It is one of the most challenging pathologies in terms of diagnosis and management due to its nonspecific presentation. However, when postoperative symptoms indicating intestinal obstruction appear, a computed tomography scan is considered the imaging modality of choice for diagnosing intussusception in adults; Conclusions: The development of postoperative peritoneal adhesions is a common cause of intestinal obstruction that can lead to complications such as intestinal intussusception, requiring additional interventions. Therefore, it is vital to identify their presence to reduce morbidity and mortality. Full article