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 Copy