Transcatheter aortic valve replacement (TAVR) is a reasonable alternative for patients with severe aortic stenosis who are at a medium or high risk from surgery, and it’s gradually extended to low-risk groups. The safety of surgery is confirmed with the advancement of technology and the improvement of surgical instruments, but surgical complications are still common. Cardiovascular collapse is the leading cause of death during the surgery and not rare. This article reported a case of cardiovascular collapse during TAVR who were successfully rescued, while literature review on the causes and treatment of cardiovascular collapse were made.
Transcatheter aortic valve replacement (TAVR) is the best treatment for severe aortic stenosis with high surgical risk, and low body weight significantly increased the risk of surgery and postoperative all-cause mortality. A case of elderly female diagnosed with severe aortic valve stenosis and extremely low body weight was presented in this article. Additionally, horizocardia and low located coronary orifice were also found in this patient, which markedly increased the risk and complexity of the TAVR procedure. During the operation, circulatory collapse occurred, and prosthetic valve was quickly released under emergency cardiopulmonary resuscitation. The operation was successful and the patient’s vital signs recovered soon. The follow-up showed that the patient was in good condition.
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.