Circulatory collapse is a common complication of transcatheter aortic valve replacement (TAVR), mainly due to new severe aortic regurgitation after balloon pre-dilation. This article reports the case of an 80-year-old female patient with severe aortic stenosis, who had a type 1 bicuspid aortic valve, with calcified aortic valve commissure between the right and left coronary cusps. During the procedure of TAVR, severe aortic regurgitation was caused by pre-dilation with 20 mm and 23 mm balloons. Then circulatory collapse and cardiogenic shock occurred. After the emergency deployment of the Venus A L26 valve, the cardiovascular hemodynamics was immediately improved. This case suggests that oversized balloon dilation should be avoided to prevent circulatory collapse caused by massive aortic regurgitation.
Citation：
YU Feicheng, TIAN Lili, HONG Xulin, WANG Bei, YU Chan, WU Lili, MA Yan, FU Guosheng. Cardiovascular collapse caused by balloon pre-dilation during transcatheter aortic valve replacement: a case report. West China Medical Journal, 2022, 37(4): 511-516. doi: 10.7507/1002-0179.202203040
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 2. 张怡, 熊恬园, 陈茂. 《2021 ESC/EACTS 心脏瓣膜病管理指南》解读:经导管瓣膜治疗策略的更新. 中国胸心血管外科临床杂志, 2021, 28(12): 1400-1408.
- 3. 潘文志, 龙愉良, 周达新, 等. 2020 年经导管瓣膜治疗主要进展. 中国胸心血管外科临床杂志, 2021, 28(4): 371-375.
- 4. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术中国专家共识(2020 更新版). 中国介入心脏病学杂志, 2020, 28(6): 301-309.
- 5. 潘文志, 张蕾, 张晓春, 等. 经导管主动脉瓣置换术中循环崩溃成功抢救 2 例. 中国介入心脏病学杂志, 2017, 25(3): 172-173.
- 6. EL-Gamel A. Cardiovascular collapse during transcatheter aortic valve replacement: diagnosis and treatment of the “perilous pentad”. Aorta (Stamford), 2013, 1(6): 276-282.
- 7. Ben-Dor I, Pichard AD, Satler LF, et al. Complications and outcome of balloon aortic valvuloplasty in high-risk or inoperable patients. JACC Cardiovasc Interv, 2010, 3(11): 1150-1156.
- 8. Moretti C, Chandran S, Vervueren PL, et al. Outcomes of patients undergoing balloon aortic valvuloplasty in the TAVI era: a multicenter registry. J Invasive Cardiol, 2015, 27(12): 547-553.
