Management strategies and possible risk factors for ventricular septal defects after transcatheter aortic valve replacement: Case series from a single center and review of literature

Sardar, Muhammad; Khan, Zubair; Abraham, Anu; Saeed, Wajeeha; Farhan, Muhammad; Kolte, Dhaval; Sharaf, Barry L.; Gordon, Paul; Sellke, Frank W.; Sodha, Neel R.; Aronow, Herbert D.; Ehsan, Afshin

doi:10.1016/j.carrev.2017.04.003

Cited by 8 publications

(12 citation statements)

References 34 publications

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“…The majority (75%) of post-TAVI VSDs were reported after balloon expandable valves (e.g. Edwards-Sapien devices) and pre-or post-dilatation was performed in most of the cases [1][2][3], also in our case post-dilatation was performed during the TAVI procedure. The iatrogenic VSD following TAVI procedure might be the result of (1) excessive aortic calcification which lacerates the interventricular septum during pre-or post-dilatation of the stenotic aortic valve and/or (2) or direct damage of the intraventricular septum during the post-dilatation of the valve.…”

Section: Discussionmentioning

confidence: 68%

“…TAVI revolutionized the management of valvular aortic stenosis by providing a safe and efficacious alternative to surgical valve replacement in higher-risk patients. Iatrogenic VSD is a rare complication following conventional surgical valve replacement and transcatheter closure of such defects with various occluder devices is described in the literature [1][2][3][4]. To date only 20 cases of iatrogenic VSD following TAVI procedure are published and only few of them were treated with a transcatheter interventional approach [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous closure of an iatrogenic ventricular septal defect following transcatheter aortic valve implantation

Ohlow

Schreiber

Lauer

2017

Journal of Cardiology Cases

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Percutaneous closure of an iatrogenic ventricular septal defect following transcatheter aortic valve implantation

Ohlow

Schreiber

Lauer

2017

Journal of Cardiology Cases

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“…2 Defekt komorového septa (VSD) predstavuje možnú komplikáciu ako TAVI, tak aj AVR s incidenciou 1 %. 3 Jednu z prvých publikácii prezentujúcich VSD pripravili Lorenz a spol. v roku 1983.…”

Section: úVodunclassified

(Interventricular septal defect as a complication of a concomitant aortic valve replacement and aortocoronary bypass surgery)

Toporcer¹,

Trejbal²,

Ledecký³

et al. 2019

Cor Vasa

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Defekt komorového septa (VSD) je vzácnou komplikáciou po chirurgickej náhrade aortálnej chlopne (AVR), ako aj po transkatétrovej implantácii aortálnej chlopne (TAVI) s incidenciou 1 %. Osemdesiatjeden ročný muž podstúpil konkomitantnú operáciu AVR s vytvorením dvoch aortokoronárnych bypassov. Niekoľko hodín po operácii došlo k hemodynamickej nestabilite pacienta a echokardiografi cké vyšetrenie potvrdilo VSD. Pacient podstúpil chirurgickú revíziu s použitím mimotelového obehu. Defekt bol uzatvorený cestou aortotómie a vykonaná bola anuloplastika trikuspidálnej chlopne. Pooperačné obdobie bolo ďalej komplikované vznikom atrioventrikulárnej blokády s nutnosťou implantácie kardiostimulátora. Literatúra uvádza viacero možnosti terapie pooperačného VSD. Na jednej strane perkutánna intervencia dovoľuje vykonať zákrok aj bez nutnosti explantácie mechanickej protézy. Na druhej strane chirurgický otvorený prístup dovoľuje okamžitú intervenciu aj pri hemodynamickej nestabilite pacienta. Ďalej je otvorený chirurgický prístup využiteľný aj pri veľmi intímnom naliehaní VSD na protézu chlopne. V literatúre je uvádzaný aj kombinovaný prístup implantácie okluzora pod vizuálnou kontrolou.

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“…The treatment strategy depends on patient hemodynamics. 2,3 In a similar case reported in the literature, computed tomography was necessary to fully characterize the lesion. 4 We demonstrate that also 3DTTE can provide accurate morphological data and may guide the subsequent management of these patients, particularly in case of percutaneous approach.…”

mentioning

confidence: 92%

“…In our case, however, an infective hypothesis cannot be completely excluded. The treatment strategy depends on patient hemodynamics …”

mentioning

confidence: 99%

A complex ventricular septal defect following transcatheter aortic valve implantation evaluated by 3D transthoracic echocardiography

et al. 2017

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Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of elderly patients with symptomatic severe aortic valve stenosis. Among the possible TAVI complications, a rare one is the annular/left ventricular outflow tract rupture.We report a rare case of a late complex ventricular septal defect (VSD) following TAVI with a balloon-expandable prosthesis, conservatively managed. Our case demonstrates the role of 3D transthoracic echocardiography (3DTTE) in the accurate diagnosis of this TAVI complication and suggests that, in some cases, it can be used as an alternative to other diagnostic tools, such as transesophageal echocardiography, cardiac catheterization, and computed tomography.

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Management strategies and possible risk factors for ventricular septal defects after transcatheter aortic valve replacement: Case series from a single center and review of literature

Cited by 8 publications

References 34 publications

Percutaneous closure of an iatrogenic ventricular septal defect following transcatheter aortic valve implantation

Percutaneous closure of an iatrogenic ventricular septal defect following transcatheter aortic valve implantation

(Interventricular septal defect as a complication of a concomitant aortic valve replacement and aortocoronary bypass surgery)

A complex ventricular septal defect following transcatheter aortic valve implantation evaluated by 3D transthoracic echocardiography

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