Mitral regurgitation during the transcatheter aortic valve replacement of a patient:a case report_West China Medical Journal

Authors：

ZHANG Yi , XIONG Tianyuan , WANG Zijie , OU Yuanweixiang , WANG Xi ,  FENG Yuan ,  CHEN Mao

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHEN Mao, Email: hmaochen@vip.sina.com

Keywords：

Transcatheter aortic valve replacement; Mitral regurgitation; Severe aortic stenosis

DOI：

10.7507/1002-0179.202002410

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This article described the clinical diagnosis and treatment of a patient with bicuspid aortic stenosis occurring severe mitral regurgitation during transcatheter aortic valve replacement. Before transcatheter aortic valve replacement, the patient’s information about medical history, signs, evaluation of CT and echocardiography were collected. After discussion by the heart team, the trans-femoral aortic valve replacement was performed. After the valve was placed during the procedure, a severe mitral regurgitation occurred. No clear causes were found, and the patient’s hemodynamics was stable. The patient recovered well during follow-up, so surgery and other treatments were not considered. This article discussed the possible mechanism and solutions of mitral regurgitation during transcatheter aortic valve replacement, and owned certain value for similar cases to refer to.

Citation： ZHANG Yi, XIONG Tianyuan, WANG Zijie, OU Yuanweixiang, WANG Xi, FENG Yuan, CHEN Mao. Mitral regurgitation during the transcatheter aortic valve replacement of a patient:a case report. West China Medical Journal, 2020, 35(4): 476-478. doi: 10.7507/1002-0179.202002410 Copy

1.	López-Aguilera J, Mesa-Rubio D, Ruiz-Ortiz M, et al. Mitral regurgitation during transcatheter aortic valve implantation: the same complication with a different mechanism. J Invasive Cardiol, 2014, 26(11): 603-608.
2.	Hekimian G, Detaint D, Messika-Zeitoun D, et al. Mitral regurgitation in patients referred for transcatheter aortic valve implantation using the Edwards Sapien prosthesis: mechanisms and early postprocedural changes. J Am Soc Echocardiogr, 2012, 25(2): 160-165.
3.	Higuchi R, Tobaru T, Saji M, et al. Pulmonary hemorrhaging caused by acute severe mitral regurgitation during transcatheter aortic valve implantation. Intern Med, 2018, 57(8): 1115-1117.
4.	Spethmann S, Dreger H, Baldenhofer G, et al. Long-term Doppler hemodynamics and effective orifice areas of Edwards SAPIEN and medtronic CoreValve prostheses after TAVI. Echocardiography, 2014, 31(3): 302-310.
5.	Kerut EK, Hanawalt C, Dearstine M, et al. Mitral systolic anterior motion (SAM) with dynamic left ventricular outflow obstruction following aortic valve replacement. Echocardiography, 2007, 24(6): 658-660.
6.	Yamashita Y, Sonoda H, Ushijima T, et al. Acute torrential mitral regurgitation during transcatheter aortic valve replacement: a case report. Surg Case Rep, 2018, 4(1): 35.
7.	Zamorano JL, Badano LP, Bruce C, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. Eur Heart J, 2011, 32(17): 2189-2214.
8.	Rodés-Cabau J, Gutiérrez M, Bagur R, et al. Incidence, predictive factors, and prognostic value of myocardial injury following uncomplicated transcatheter aortic valve implantation. J Am Coll Cardiol, 2011, 57(20): 1989-1999.
9.	Goel SS, Zuck V, Nallamothu N, et al. Successful MitraClip for severe mitral regurgitation secondary to papillary muscle rupture as a complication of transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2018, 11(6): e47-e48.
10.	Okada A, Kanzaki H, Amaki M, et al. Successful treatment of mitral regurgitation after transapical transcatheter aortic valve implantation by percutaneous edge-to-edge mitral valve repair (MitraClip®) - the first combination therapy performed in Japan. Intern Med, 2018, 57(8): 1105-1109.

1. López-Aguilera J, Mesa-Rubio D, Ruiz-Ortiz M, et al. Mitral regurgitation during transcatheter aortic valve implantation: the same complication with a different mechanism. J Invasive Cardiol, 2014, 26(11): 603-608.
2. Hekimian G, Detaint D, Messika-Zeitoun D, et al. Mitral regurgitation in patients referred for transcatheter aortic valve implantation using the Edwards Sapien prosthesis: mechanisms and early postprocedural changes. J Am Soc Echocardiogr, 2012, 25(2): 160-165.
3. Higuchi R, Tobaru T, Saji M, et al. Pulmonary hemorrhaging caused by acute severe mitral regurgitation during transcatheter aortic valve implantation. Intern Med, 2018, 57(8): 1115-1117.
4. Spethmann S, Dreger H, Baldenhofer G, et al. Long-term Doppler hemodynamics and effective orifice areas of Edwards SAPIEN and medtronic CoreValve prostheses after TAVI. Echocardiography, 2014, 31(3): 302-310.
5. Kerut EK, Hanawalt C, Dearstine M, et al. Mitral systolic anterior motion (SAM) with dynamic left ventricular outflow obstruction following aortic valve replacement. Echocardiography, 2007, 24(6): 658-660.
6. Yamashita Y, Sonoda H, Ushijima T, et al. Acute torrential mitral regurgitation during transcatheter aortic valve replacement: a case report. Surg Case Rep, 2018, 4(1): 35.
7. Zamorano JL, Badano LP, Bruce C, et al. EAE/ASE recommendations for the use of echocardiography in new transcatheter interventions for valvular heart disease. Eur Heart J, 2011, 32(17): 2189-2214.
8. Rodés-Cabau J, Gutiérrez M, Bagur R, et al. Incidence, predictive factors, and prognostic value of myocardial injury following uncomplicated transcatheter aortic valve implantation. J Am Coll Cardiol, 2011, 57(20): 1989-1999.
9. Goel SS, Zuck V, Nallamothu N, et al. Successful MitraClip for severe mitral regurgitation secondary to papillary muscle rupture as a complication of transcatheter aortic valve replacement. JACC Cardiovasc Interv, 2018, 11(6): e47-e48.
10. Okada A, Kanzaki H, Amaki M, et al. Successful treatment of mitral regurgitation after transapical transcatheter aortic valve implantation by percutaneous edge-to-edge mitral valve repair (MitraClip®) - the first combination therapy performed in Japan. Intern Med, 2018, 57(8): 1105-1109.

West China Medical Journal

Mitral regurgitation during the transcatheter aortic valve replacement of a patient:a case report

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