Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report
Abstract Background Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgery. However, there is a risk of surgical manipulation causing detachment of a lesion of the aortic valve, which can result in various embolisms. Case presentation An 87-year-old woman with symptomatic sev...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-11-01
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| Series: | JA Clinical Reports |
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| Online Access: | https://doi.org/10.1186/s40981-023-00669-x |
| _version_ | 1797630353738825728 |
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| author | Yuki Mitsuta Shingo Nakamura Yumiko Uemura Koichiro Tashima Takafumi Oyoshi Naoyuki Hirata |
| author_facet | Yuki Mitsuta Shingo Nakamura Yumiko Uemura Koichiro Tashima Takafumi Oyoshi Naoyuki Hirata |
| author_sort | Yuki Mitsuta |
| collection | DOAJ |
| description | Abstract Background Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgery. However, there is a risk of surgical manipulation causing detachment of a lesion of the aortic valve, which can result in various embolisms. Case presentation An 87-year-old woman with symptomatic severe aortic valve stenosis was scheduled for transfemoral TAVI under monitored anesthesia. Preoperative examination revealed severe calcification of the aortic valve, but there was no calcification in the ascending aorta. After a delivery catheter system passed the aortic valve, left radial arterial pressure dropped significantly, and complete atrioventricular block (CAVB) occurred. Catecholamine administration and ventricular pacing improved hemodynamics, and a self-expandable valve was implanted. CAVB resolved after surgery, but her state of consciousness was poor, and her left hand became ischemic. Imaging studies revealed multiple embolic infarcts in her bilateral cerebrum and cerebellum. Conclusions It should be noted that there is a risk of detachment of a calcified lesion of the aortic valve during TAVI, which can cause embolisms not only in the brain but also in the extremities and coronary arteries. |
| first_indexed | 2024-03-11T11:07:10Z |
| format | Article |
| id | doaj.art-14a560c90b4c4bc4b027c122f8cf8ec4 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-03-11T11:07:10Z |
| publishDate | 2023-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-14a560c90b4c4bc4b027c122f8cf8ec42023-11-12T12:09:34ZengSpringerOpenJA Clinical Reports2363-90242023-11-01911510.1186/s40981-023-00669-xBilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case reportYuki Mitsuta0Shingo Nakamura1Yumiko Uemura2Koichiro Tashima3Takafumi Oyoshi4Naoyuki Hirata5Department of Anesthesiology, Japanese Red Cross Kumamoto HospitalDepartment of Anesthesiology, Kumamoto University HospitalDepartment of Anesthesiology, Minamata City General Hospital & Medical CenterDepartment of Anesthesiology, Kumamoto University HospitalDepartment of Anesthesiology, Kumamoto University HospitalDepartment of Anesthesiology, Kumamoto University HospitalAbstract Background Transcatheter aortic valve implantation (TAVI) is a minimally invasive surgery. However, there is a risk of surgical manipulation causing detachment of a lesion of the aortic valve, which can result in various embolisms. Case presentation An 87-year-old woman with symptomatic severe aortic valve stenosis was scheduled for transfemoral TAVI under monitored anesthesia. Preoperative examination revealed severe calcification of the aortic valve, but there was no calcification in the ascending aorta. After a delivery catheter system passed the aortic valve, left radial arterial pressure dropped significantly, and complete atrioventricular block (CAVB) occurred. Catecholamine administration and ventricular pacing improved hemodynamics, and a self-expandable valve was implanted. CAVB resolved after surgery, but her state of consciousness was poor, and her left hand became ischemic. Imaging studies revealed multiple embolic infarcts in her bilateral cerebrum and cerebellum. Conclusions It should be noted that there is a risk of detachment of a calcified lesion of the aortic valve during TAVI, which can cause embolisms not only in the brain but also in the extremities and coronary arteries.https://doi.org/10.1186/s40981-023-00669-xTranscatheter aortic valve implantationStrokeEmbolism |
| spellingShingle | Yuki Mitsuta Shingo Nakamura Yumiko Uemura Koichiro Tashima Takafumi Oyoshi Naoyuki Hirata Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report JA Clinical Reports Transcatheter aortic valve implantation Stroke Embolism |
| title | Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report |
| title_full | Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report |
| title_fullStr | Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report |
| title_full_unstemmed | Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report |
| title_short | Bilateral multiple stroke, left upper extremity ischemia, and transient complete atrioventricular block in transcatheter aortic valve implantation: a case report |
| title_sort | bilateral multiple stroke left upper extremity ischemia and transient complete atrioventricular block in transcatheter aortic valve implantation a case report |
| topic | Transcatheter aortic valve implantation Stroke Embolism |
| url | https://doi.org/10.1186/s40981-023-00669-x |
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