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Case Reports
. 2017:2017:1834394.
doi: 10.1155/2017/1834394. Epub 2017 Sep 28.

Aorto-Right Ventricular Shunt after TAVR: Rare Complication of Common Procedure

Abdelkader Almanfi  1 , Ahmad Qurie  1 , Neil Strickman  1
Affiliations
Case Reports

Aorto-Right Ventricular Shunt after TAVR: Rare Complication of Common Procedure

Abdelkader Almanfi et al. Case Rep Cardiol. 2017.

Abstract

Background: The primary treatment of symptomatic aortic stenosis is aortic valve replacement. Instead of open chest surgery, transcatheter aortic valve replacement (TAVR) is an alternative intervention for high-risk surgical candidates.

Clinical case: A 92-year-old male presented with progressive exertional dyspnea and recurrent syncopal attacks secondary to severe AS. The patient underwent successful transfemoral TAVR with 29 mm Edwards SAPIEN XT valve. His postoperative course was complicated by aorto-right ventricular shunt. The patient's clinical course was followed up for one year.

Conclusion: This case reports the incidence and clinical course of one of the rare complications of TAVR, aorto-right ventricular fistula. Conservative medical management is appropriate in hemodynamically stable patients with this specific complication.

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Figures

Figure 1
Figure 1
Figure 2
Figure 2
1-Month follow-up: TTE 2D ECHO; this shows continuous wave Doppler across the shunt between the aorta and RV.
Figure 3
Figure 3
1-Year follow-up: TTE 2D ECHO with color flow shows the residual aorto-RV shunt with a continuous wave Doppler, which demonstrates significant reduction in the velocity compared to the initial measurements.
See this image and copyright information in PMC

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