Emergency transcatheter aortic valve replacement for a patient with decompensated severe aortic stenosis accompanied by cardiorenal syndrome: a case report

BMC Cardiovasc Disord. 2018 Mar 20;18(1):55. doi: 10.1186/s12872-018-0791-7.

Abstract

Background: Severe aortic stenosis (AS) may lead to acute decompensated heart failure resistant to medical treatment. Here, we report a successful emergent transcatheter aortic valve replacement (TAVR) in a patient presenting with decompensated severe AS accompanied by cardiorenal syndrome.

Case presentation: A 82-year-old man presented at our emergency department with aggravated dyspnea. His chest X-ray showed bilateral pulmonary edema, and laboratory examination revealed acute kidney injury. Transthoracic echocardiography (TTE) revealed low-flow, low-gradient AS with decreased left ventricular systolic function. With a diagnosis of acute decompensated heart failure combined with cardiorenal syndrome, we opted to perform emergent TAVR. Ultimately, we successfully performed emergent TAVR using only TTE and 3-D transesophageal echocardiography (TEE) measurements.

Conclusions: This report presents a case of decompensated severe AS accompanied by cardiorenal syndrome that was treated successfully with emergent TAVR. Thus, emergent TAVR using only echocardiography measurements is a feasible and safe option for treating decompensated heart failure accompanied by cardiorenal syndrome the clinical setting.

Keywords: Cardiorenal syndrome; Heart failure; Transcatheter aortic valve replacement.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology
  • Aortic Valve / surgery*
  • Aortic Valve Stenosis / complications
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery*
  • Cardio-Renal Syndrome / diagnosis
  • Cardio-Renal Syndrome / etiology*
  • Cardio-Renal Syndrome / physiopathology
  • Echocardiography, Doppler, Color
  • Echocardiography, Three-Dimensional
  • Echocardiography, Transesophageal
  • Electrocardiography
  • Emergencies
  • Heart Failure / diagnosis
  • Heart Failure / etiology*
  • Heart Failure / physiopathology
  • Hemodynamics
  • Humans
  • Male
  • Severity of Illness Index
  • Transcatheter Aortic Valve Replacement*
  • Treatment Outcome