Mitral Valve Stenosis after Transcatheter Aortic Valve Replacement: Case Report and Review of the Literature.
Cardiovasc Revasc Med
; 20(12): 1196-1202, 2019 Dec.
Article
em En
| MEDLINE
| ID: mdl-30905659
ABSTRACT
Mitral stenosis is a rare and potentially severe complication of transcatheter aortic valve replacement (TAVR). Given the anatomic coupling and interdependence of the aortic and mitral valves, it comes by itself that procedures (either surgical or percutaneous) involving the aortic valve imply the risk of altering mitral valve function. Indeed, transcatheter aortic prostheses may impair adequate anterior mitral leaflet (AML) opening, especially when implanted in a "low" position, thus resulting in high transvalvular gradients. Hereby, we report the case of a 71-year-old male with symptomatic severe aortic stenosis and a history of previous surgical mitral valve repair who underwent TAVR with a self-expandable prosthesis. Notwithstanding an acceptable angiographic position, the prosthetic frame was shown to interfere with the AML, as evidenced by augmented transmitral gradients; nonetheless, pulmonary artery pressures remained unchanged, and the patient experienced symptomatic improvement. Therefore, a conservative approach was chosen and the patient was discharged home after medical therapy optimization. Moreover, we provide a review of the available literature regarding the incidence, predictors and possible management of this infrequent complication.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Estenose da Valva Aórtica
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Substituição da Valva Aórtica Transcateter
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Hemodinâmica
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Valva Mitral
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Estenose da Valva Mitral
Tipo de estudo:
Prognostic_studies
Limite:
Aged
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Humans
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Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article