Complex cardiac surgery in a high-risk patient with new-onset severe mitral regurgitation and aorta to right ventricular fistula after transcatheter aortic valve implantation: a case report

European Heart Journal. Case Reports
Mario Verdugo-MarcheseMatthias Kirsch

Abstract

Transcatheter aortic valve implantation (TAVI) is the procedure of choice for aortic stenosis in high surgical risk patients, but it is no free from complications. A 86-year-old patient with severe aortic stenosis underwent TAVI 3 years ago with an Edwards Sapiens valve by femoral access. In the echocardiography follow-up, an aorta-right ventricular (Ao-RV) fistula was noted with restrictive flow and no significant shunt and it was treated conservatively. Three years after TAVI, the patient underwent cardiac surgery because of worsening heart failure due to a severe degenerative mitral regurgitation with tethering of P2 due to left ventricular remodelling, a posterior jet of severe regurgitation, and left ventricular dilatation. Surgical replacement of the TAVI and aortic root with a bioprosthesis (Medtronic Freestyle) and direct closure of the fistula was performed along with the mitral valve replacement. The patient was discharged with a good clinical result and no evidence of remaining Ao-RV fistula at transthoracic echocardiography. Aorta-right ventricular fistula is a rare entity. Most reported cases arise after rupture of a congenital coronary sinus aneurism, endocarditis, trauma, and aortic valve or aortic root surgery. ...Continue Reading

References

Jan 25, 2005·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Jeroen WalpotJudith den Braber
Sep 24, 2014·Nature Reviews. Cardiology·Nassir M ThaljiHartzell V Schaff
Aug 23, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Kenta NakamuraIgnacio Inglessis-Azuaje
Sep 14, 2016·Anesthesia and Analgesia·Antonio Graham, Charles H Brown
Mar 18, 2017·The New England Journal of Medicine·Michael J ReardonUNKNOWN SURTAVI Investigators
Sep 10, 2017·European Heart Journal·Helmut BaumgartnerUNKNOWN ESC Scientific Document Group
Jan 13, 2018·Heart Views : the Official Journal of the Gulf Heart Association·Monoj K KondaVishal Gupta

❮ Previous
Next ❯

Methods Mentioned

BETA
coronary bypass

Related Concepts

Related Feeds

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.

Acute viral rhinopharyngitis

Acute viral rhinopharyngitis, also known as "common cold", is an acute, self-limiting viral infection of the upper respiratory tract involving the nose, sinuses, pharynx and larynx. Discover the latest research on acute viral rhinopharyngitis here.