Successfully Treated Nonocclusive Mesenteric Ischemia After Transcatheter Aortic Valve Replacement

Ann Thorac Surg. 2017 Feb;103(2):e171-e173. doi: 10.1016/j.athoracsur.2016.07.064.

Abstract

An 80-year-old man with symptomatic severe aortic stenosis underwent transcatheter aortic valve replacement. Postoperatively, the patient was hemodynamically stable without inotropic or mechanical support. Approximately 30 hours after the procedure, he developed severe abdominal pain, and a blood test result showed elevated serum lactate level. We suspected nonocclusive mesenteric ischemia and performed emergency selective angiography of the superior mesenteric artery, which showed vasospasm. We confirmed the diagnosis of nonocclusive mesenteric ischemia, and it was treated successfully with intraarterial infusion of vasodilators into the superior mesenteric artery.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / surgery
  • Computed Tomography Angiography / methods*
  • Follow-Up Studies
  • Humans
  • Infusions, Intra-Arterial
  • Male
  • Mesenteric Artery, Superior / diagnostic imaging
  • Mesenteric Artery, Superior / drug effects*
  • Mesenteric Ischemia / diagnostic imaging*
  • Mesenteric Ischemia / drug therapy
  • Mesenteric Ischemia / etiology
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / drug therapy
  • Postoperative Complications / physiopathology
  • Risk Assessment
  • Severity of Illness Index
  • Transcatheter Aortic Valve Replacement / adverse effects*
  • Transcatheter Aortic Valve Replacement / methods
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use*

Substances

  • Vasodilator Agents