A case report: black oesophagus as a possible complication of transcatheter aortic valve implantation

Inês S Gonçalves; Armando L Bordalo E Sá; Narcisa Fatela; Pedro Canas da Silva

doi:10.1093/ehjcr/ytz069

A case report: black oesophagus as a possible complication of transcatheter aortic valve implantation

Eur Heart J Case Rep. 2019 Jun 1;3(2):ytz069. doi: 10.1093/ehjcr/ytz069.

Authors

Inês S Gonçalves¹, Armando L Bordalo E Sá¹, Narcisa Fatela², Pedro Canas da Silva¹

Affiliations

¹ Cardiology Department, Hospital Universitário de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, CAML, CCUL, Lisbon School of Medicine of the Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal.
² Gastroenterology Department, Hospital Universitário de Santa Maria, Centro Hospitalar Universitário de Lisboa Norte, Lisbon School of Medicine of the Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal.

Abstract

Background: The increasing number of transcatheter aortic valve implantation (TAVI) in the last few years has unveiled a unique set of events and complications that need prompt recognition and management in order to improve patient outcomes, often involving a multidisciplinary team.

Case summary: We present a case of a 86-year-old woman with symptomatic severe aortic stenosis that underwent a TAVI and, in the post-procedure period, presented with acute abundant haematemesis, haemodynamic instability, and haemoglobin drop. The diagnosis of acute necrotizing oesophagitis (ANE) was made by upper gastrointestinal endoscopy.

Discussion: Acute necrotizing oesophagitis is a rare entity caused usually by an ischaemic insult in the presence of predisposing factors; it has a high rate of complications and mortality. To the best of our knowledge, this is the first clinical case report to describe the occurrence of ANE as a possible complication of TAVI and is also an example of the importance of the multidisciplinary approach of these complex patients, which extends even beyond the concept of Heart Team.

Keywords: Acute necrotizing oesophagitis; Black oesophagus; Case report; Transcatheter aortic valve implantation.