Development of acute severe right heart failure after transcatheter aortic valve implantation in patient with left ventricle assist device-acquired aortic regurgitation.

Development of acute severe right heart failure after transcatheter aortic valve implantation in patient with left ventricle assist device-acquired aortic regurgitation. Turk Kardiyol Dern Ars. 2020 Jul;48(5):545-551 Authors: Bayram Z, Doğan C, Gürcü E, Kaymaz C, Özdemir N Abstract A 58-year-old man with a left ventricular assist device (LVAD), which had been implanted 1 year earlier, presented with rest dyspnea. Moderate to severe aortic regurgitation (AR), pre-postcapillary pulmonary hypertension, modarete right ventricular (RV) failure, and low cardiac output were observed at presentation. Transcatheter aortic valve implantation (TAVI) was performed to treat the AR and a self-expandable aortic valve was implanted. Within minutes, hypotension, RV and inferior vena cava dilatation, and left atrial (LA) and left ventricular (LV) collapse occurred and persisted despite LVAD speed reduction. It was observed that severe RV failure had developed and venoarterial extracorporeal membrane oxygenation (VA-ECMO) was applied. Following VA-ECMO treatment, the RV dimensions decreased, and the LA and LV dimensions began to increase, as well as the LVAD flow. Weaning from VA-ECMO was unsuccessful and exitus occurred on the fifth day after TAVI secondary to RV failure. It was surmised that the decrease in blood circulation from the aorta to the LV after treatment of severe AR with TAVI caused an acute increase in the cardiac output and the RV p...
Source: Turk Kardiyoloji Dernegi arsivi - Category: Cardiology Authors: Tags: Turk Kardiyol Dern Ars Source Type: research