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Case Reports
. 2017 Apr 7:2017:bcr2017219247.
doi: 10.1136/bcr-2017-219247.

Aorto-right ventricular fistula following transcatheter aortic valve implantation using a 29 mm SAPIEN XT valve

Kazuki Hagiwara  1 , Naritatsu Saito  2 , Kazuhiro Yamazaki  1 , Takeshi Kimura  1
Affiliations
Case Reports

Aorto-right ventricular fistula following transcatheter aortic valve implantation using a 29 mm SAPIEN XT valve

Kazuki Hagiwara et al. BMJ Case Rep. .

Abstract

An 83-year-old man with severe symptomatic aortic valve stenosis underwent transcatheter aortic valve implantation (TAVI) using a 29 mm SAPIEN XT valve. He was haemodynamically stable, but developed haemolytic anaemia. Transthoracic echocardiography conducted 7 days after TAVI revealed an abnormal continuous flow from the right sinus of Valsalva adjacent to the implanted valve to the right ventricle. The amount of shunt flow was considered small and the patient was managed with diuretics successfully. He was discharged from the hospital 35 days after TAVI. He was doing well at 9 months after TAVI, despite persistence of the aorto-right ventricular fistula on repeat echocardiographic examinations.

Keywords: General surgery; Medical education; Resuscitation.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Multislice CT images. (A) Heavy calcification in all three aortic valve cusps. (B) A 6.5 mm longitudinal calcification in the right cusp.
Figure 2
Figure 2
Fluoroscopy images during transcatheter aortic valve implantation. (A) A 29 mm SAPIEN XT valve is implanted with +2 cc balloon volume. (B) Final aortography showing mild paravalvular regurgitation.
Figure 3
Figure 3
Transthoracic echocardiography images. (A) An abnormal colour jet (arrow) from the right sinus of Valsalva to the right ventricle. (B) The flow is continuous in systole and diastole.
See this image and copyright information in PMC

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