Abstract
BackgroundMitral regurgitation after transcatheter aortic valve implantation (TAVI) can be caused by various etiologies.Case presentationAn 81-year-old woman with mild mitral regurgitation and complete right bundle branch block was scheduled to undergo TAVI under general anesthesia. After the deployment of the prosthetic valve, electrocardiography depicted a wide QRS wave and bradycardia, suggestive of complete atrioventricular block. Although there was no lesion indicative of tissue injury to the valve itself, worsening of mitral regurgitation was identified on transesophageal echocardiography. The hemodynamic condition was stable, and no additional procedure was performed. Electrocardiography depicted a return to a narrow QRS wave 3 days after surgery, and the mitral regurgitation appeared comparable to the preoperative grade. We assumed that the worsening of mitral regurgitation was caused by dyssynchrony in the left ventricle due to the conduction disorder.ConclusionsMitral regurgitation after TAVI needs observation, including the determination of the etiology and treatment principle.
Highlights
Mitral regurgitation after transcatheter aortic valve implantation (TAVI) can be caused by various etiologies.Case presentation: An 81-year-old woman with mild mitral regurgitation and complete right bundle branch block was scheduled to undergo TAVI under general anesthesia
The frequency of transcatheter aortic valve implantation (TAVI) for aortic valve stenosis has increased owing to its indications in patients with a myriad of cardiac complications that may affect the prognosis
The bioprosthetic valve used in this patient, i.e., Evolute PRO ® (Medtronic, Irvine CA), is a self-expanding valve, which is associated with a greater possibility of postoperative left bundle branch block or permanent pacemaker implantation due to complete atrioventricular blockade compared to a balloon-expandable valve
Summary
Mitral regurgitation after transcatheter aortic valve implantation (TAVI) can be caused by various etiologies.Case presentation: An 81-year-old woman with mild mitral regurgitation and complete right bundle branch block was scheduled to undergo TAVI under general anesthesia. We report a case of an altered severity of mitral regurgitation resulting from a change in left ventricular conduction after Evolute-PRO® (Medtronic, Irvine CA) implantation. Discussion The persistence of moderate or severe mitral regurgitation after TAVI is associated with worsening of prognosis and is, a highly critical issue [1].
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