A Case of TAVR Complicated by Severe Functional Mitral Regurgitation

Guillaume Lepage-Mireault; Giuseppe Martucci; Nicolo Piazza; Pavel Overtchouk; Jean Buithieu; Negareh Mousavi; Benoît De Varennes; Kevin Lachapelle; Marco Spaziano

doi:10.1016/j.cjca.2020.07.238

A Case of TAVR Complicated by Severe Functional Mitral Regurgitation

Can J Cardiol. 2020 Dec;36(12):1977.e13-1977.e15. doi: 10.1016/j.cjca.2020.07.238. Epub 2020 Jul 29.

Authors

Guillaume Lepage-Mireault¹, Giuseppe Martucci¹, Nicolo Piazza¹, Pavel Overtchouk¹, Jean Buithieu¹, Negareh Mousavi¹, Benoît De Varennes², Kevin Lachapelle², Marco Spaziano³

Affiliations

¹ Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada.
² Division of Cardiac Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
³ Division of Cardiology, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: marco.spaziano@mcgill.ca.

PMID: 32735847
DOI: 10.1016/j.cjca.2020.07.238

Abstract

Mitral regurgitation (MR) is a known complication of transcatheter aortic valve replacement (TAVR). We report a case of a 90-year-old man with severe symptomatic aortic stenosis who underwent elective TAVR. The procedure was complicated by severe functional MR from left ventricular stunning and dilatation caused by hypotension throughout the procedure. An Impella CP (Abiomed, Inc, Danvers, MA) was inserted to unload the left ventricle and decrease its size with subsequent improvement in MR severity, which was sustained after Impella CP removal. In conclusion, we present the first case of successful management of post-TAVR severe functional MR with an Impella CP.

Publication types

Case Reports
Video-Audio Media

MeSH terms

Aged, 80 and over
Aortic Valve Stenosis / surgery*
Aortic Valve* / diagnostic imaging
Aortic Valve* / pathology
Aortic Valve* / surgery
Assisted Circulation* / instrumentation
Assisted Circulation* / methods
Dilatation, Pathologic / diagnosis
Dilatation, Pathologic / etiology
Dilatation, Pathologic / therapy
Echocardiography, Transesophageal / methods
Heart Ventricles* / pathology
Heart Ventricles* / physiopathology
Heart-Assist Devices*
Humans
Male
Mitral Valve Insufficiency* / diagnosis
Mitral Valve Insufficiency* / etiology
Mitral Valve Insufficiency* / physiopathology
Mitral Valve Insufficiency* / therapy
Postoperative Complications* / diagnosis
Postoperative Complications* / etiology
Postoperative Complications* / physiopathology
Postoperative Complications* / therapy
Severity of Illness Index
Surgery, Computer-Assisted / methods
Transcatheter Aortic Valve Replacement* / adverse effects
Transcatheter Aortic Valve Replacement* / methods
Treatment Outcome