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      "titulo" => "Iatrogenic fistula between the aorta and the right ventricular outflow tract after Melody valve implantation&#58; Case report and literature review"
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            "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#40;A and B&#41; Computed tomography showing the aortic end of the iatrogenic fistula near the right coronary ostium and the pulmonary end just proximal to the pulmonary valve&#59; &#40;C and D&#41; transthoracic echocardiogram&#44; parasternal long- and short-axis views of the iatrogenic fistula &#40;&#42;&#41; between the aortic arch and the right ventricular outflow tract &#40;RVOT&#41;&#59; &#40;E and F&#41; aortic and conduit angiographies before percutaneous pulmonary valve implantation &#40;PPVI&#41;&#59; &#40;G&#41; conduit angiography after pre-stenting and after PPVI&#59; &#40;H&#41; aortic angiography showing opacification of the RVOT&#46;</p>"
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    "titulo" => "Iatrogenic dissection of the ascending aorta after transcatheter aortic valve implantation treated conservatively"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Intracardiac echocardiography images&#58; &#40;A&#41; intimal flap dividing the aorta into a true lumen&#44; in which the tip of the pigtail catheter can be seen &#40;arrow&#41;&#44; and a false lumen &#40;&#42;&#41;&#59; &#40;B&#41; color Doppler with virtually no systolic antegrade flow in the false lumen&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 90-year-old female with severe symptomatic aortic stenosis was admitted for transcatheter aortic valve implantation &#40;TAVI&#41;&#46; A 26-mm Edwards SAPIEN valve was implanted through a transfemoral approach&#46; After the final aortic angiogram a subtraction image was noted from the aortic root just above the right coronary sinus &#40;RCS&#41; to the mid ascending aorta &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; The intracardiac echocardiogram suggested an aortic dissection&#44; showing an enlarged ascending aorta with an intimal flap without clear flow in the false lumen &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#46; The hypothesis of dissection caused by a small tear at the level of the RCS was confirmed by computed tomography &#40;CT&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#46; After heart team discussion it was decided to treat the complication conservatively&#44; since the patient had no symptoms&#44; and she was started on labetalol&#46; A transthoracic echocardiogram was performed that showed good valvular performance without paravalvular leakage&#46; The patient was discharged home after two days&#46; Three months later her exercise capacity had improved and the control CT showed resolution of the dissection &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">We believe this case highlights the importance of proper assessment of angiographic images that can prompt a search for aortic dissection using other diagnostic means&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Iatrogenic acute aortic dissection complicates 0-1&#46;9&#37; of TAVI cases&#46; The best treatment remains controversial&#44; as mortality in patients treated either with surgery &#40;57-80&#37;&#41; or conservatively &#40;58&#37; at 30 days&#41; is very high&#46; Particularly in very elderly patients&#44; a watchful waiting strategy may be reasonable&#44; as in the case presented here&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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