Abstract 2113: Transcatheter Aortic Valve Replacement (TAVR) Complication: Intraoperative Mitral Regurgitation.

• DOI: 10.1161/atvb.44.suppl_1.2113
• Publication Date: 2024-07-24T13:03:55Z
• Authors: Priyanka Singh; Assad Marwat; Afsha Aurshina; Anaba Jajja; Farid Khan; Alon Yarkoni; Rasha Aurshiya
• Keywords: Valve replacement; Mitral valve replacement

Introduction: Transcatheter aortic valve replacement (TAVR) is the preferred treatment for stenosis (AS) in patients with high surgical risk. This case report delves into a rare, significant intra-procedural mitral regurgitation (MR) of TAVR. Case Presentation: A 94-year-old female severe AS and STS score 3.9% underwent recent 2D ECHO revealed AS. CT angiogram pre-TAVR exhibited scattered coronary artery calcifications, calcification, calcified atherosclerotic plaque. During procedure, 26mm CoreValve was deployed appropriately, no perivalvular leak observed on angiography transesophageal echocardiography (TEE). However, post-deployment, patient experienced sudden drop blood pressure, TEE MR, not detected previous studies. Treatment included pressors, non-invasive positive pressure ventilation, diuretics, resulting favorable response. Subsequent TTE 4th day showed improvement MR. one-year follow-up only trace confirming normal functioning prosthetic valve. Discussion: Acute an uncommon TAVR complication potential morbidity mortality. Various studies propose multiple mechanisms, this case, we attribute it to intraoperative global hypoperfusion causing transient Hypoperfusion papillary muscle disrupted leaflet coaptation, leading as supported by its resolution improved pressure. Studies have reported different mechanisms acute including rupture, perforation, guidewire impingement, hypoperfusion, some indicating higher incidence compared other types. Conclusion: Given rarity MR during unclear pathophysiology, there are established society guidelines management. With becoming routine, further clinical trials crucial optimizing treatment, head-to-head comparisons valves procedural techniques, developing comprehensive management strategies based specific complication.