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Published in: BMC Cardiovascular Disorders 1/2018

Open Access 01-12-2018 | Case report

Emergency transcatheter aortic valve replacement for a patient with decompensated severe aortic stenosis accompanied by cardiorenal syndrome: a case report

Authors: Hongju Kim, Jung-Hee Lee

Published in: BMC Cardiovascular Disorders | Issue 1/2018

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Abstract

Background

Severe aortic stenosis (AS) may lead to acute decompensated heart failure resistant to medical treatment. Here, we report a successful emergent transcatheter aortic valve replacement (TAVR) in a patient presenting with decompensated severe AS accompanied by cardiorenal syndrome.

Case presentation

A 82-year-old man presented at our emergency department with aggravated dyspnea. His chest X-ray showed bilateral pulmonary edema, and laboratory examination revealed acute kidney injury. Transthoracic echocardiography (TTE) revealed low-flow, low-gradient AS with decreased left ventricular systolic function. With a diagnosis of acute decompensated heart failure combined with cardiorenal syndrome, we opted to perform emergent TAVR. Ultimately, we successfully performed emergent TAVR using only TTE and 3-D transesophageal echocardiography (TEE) measurements.

Conclusions

This report presents a case of decompensated severe AS accompanied by cardiorenal syndrome that was treated successfully with emergent TAVR. Thus, emergent TAVR using only echocardiography measurements is a feasible and safe option for treating decompensated heart failure accompanied by cardiorenal syndrome the clinical setting.
Literature
1.
go back to reference Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370:1790–8.CrossRefPubMed Adams DH, Popma JJ, Reardon MJ, Yakubov SJ, Coselli JS, Deeb GM, et al. Transcatheter aortic-valve replacement with a self-expanding prosthesis. N Engl J Med. 2014;370:1790–8.CrossRefPubMed
2.
go back to reference Shih T, Paone G, Theurer PF, McDonald D, Shahian DM, Prager RL. The society of thoracic surgeons adult cardiac surgery database version 2.73: more is better. Ann Thorac Surg. 2015;100:516–21.CrossRefPubMed Shih T, Paone G, Theurer PF, McDonald D, Shahian DM, Prager RL. The society of thoracic surgeons adult cardiac surgery database version 2.73: more is better. Ann Thorac Surg. 2015;100:516–21.CrossRefPubMed
3.
go back to reference Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P, et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J. 2005;26:2714–20.CrossRefPubMed Iung B, Cachier A, Baron G, Messika-Zeitoun D, Delahaye F, Tornos P, et al. Decision-making in elderly patients with severe aortic stenosis: why are so many denied surgery? Eur Heart J. 2005;26:2714–20.CrossRefPubMed
4.
go back to reference Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609–20.CrossRefPubMed Leon MB, Smith CR, Mack MJ, Makkar RR, Svensson LG, Kodali SK, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2016;374:1609–20.CrossRefPubMed
5.
go back to reference Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Søndergaard L, Mumtaz M, et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2017;376:1321–31.CrossRefPubMed Reardon MJ, Van Mieghem NM, Popma JJ, Kleiman NS, Søndergaard L, Mumtaz M, et al. Surgical or transcatheter aortic-valve replacement in intermediate-risk patients. N Engl J Med. 2017;376:1321–31.CrossRefPubMed
6.
8.
go back to reference Frerker C, Schewel J, Schlüter M, Schewel D, Ramadan H, Schmidt T, et al. Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis. EuroIntervention. 2016;11:1530–6.CrossRefPubMed Frerker C, Schewel J, Schlüter M, Schewel D, Ramadan H, Schmidt T, et al. Emergency transcatheter aortic valve replacement in patients with cardiogenic shock due to acutely decompensated aortic stenosis. EuroIntervention. 2016;11:1530–6.CrossRefPubMed
9.
go back to reference Van Belle E, Juthier F, Susen S, Vincentelli A, Iung B, Dallongeville J, et al. Postprocedural aortic regurgitation in balloon-expandable and self-expandable transcatheter aortic valve replacement procedures: analysis of predictors and impact on long-term mortality: insights from the FRANCE2 registry. Circulation. 2014;129:1415–27.CrossRefPubMed Van Belle E, Juthier F, Susen S, Vincentelli A, Iung B, Dallongeville J, et al. Postprocedural aortic regurgitation in balloon-expandable and self-expandable transcatheter aortic valve replacement procedures: analysis of predictors and impact on long-term mortality: insights from the FRANCE2 registry. Circulation. 2014;129:1415–27.CrossRefPubMed
10.
go back to reference Sinning JM, Hammerstingl C, Vasa-Nicotera M, Adenauer V, Lema Cachiguango SJ, Scheer AC, et al. Aortic regurgitation index defines severity of peri-prosthetic regurgitation and predicts outcome in patients after transcatheter aortic valve implantation. J Am Coll Cardiol. 2012;59:1134–41.CrossRefPubMed Sinning JM, Hammerstingl C, Vasa-Nicotera M, Adenauer V, Lema Cachiguango SJ, Scheer AC, et al. Aortic regurgitation index defines severity of peri-prosthetic regurgitation and predicts outcome in patients after transcatheter aortic valve implantation. J Am Coll Cardiol. 2012;59:1134–41.CrossRefPubMed
11.
go back to reference Delgado V, Schuijf JD, Bax JJ. Pre-operative aortic valve implantation evaluation: multimodality imaging. EuroIntervention. 2010;6(Suppl G):G38–47.PubMed Delgado V, Schuijf JD, Bax JJ. Pre-operative aortic valve implantation evaluation: multimodality imaging. EuroIntervention. 2010;6(Suppl G):G38–47.PubMed
12.
go back to reference Zaman S, Gooley R, McCormick L, Harper R, Meredith IT. Pre-transcatheter aortic valve implantation workup in the cardiac catheterisation laboratory. Heart Lung Circ. 2015;24:1162–70.CrossRefPubMed Zaman S, Gooley R, McCormick L, Harper R, Meredith IT. Pre-transcatheter aortic valve implantation workup in the cardiac catheterisation laboratory. Heart Lung Circ. 2015;24:1162–70.CrossRefPubMed
13.
go back to reference Altiok E, Koos R, Schroder J, Brehmer K, Hamada S, Becker M, et al. Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation. Heart. 2011;97:1578–84.CrossRefPubMed Altiok E, Koos R, Schroder J, Brehmer K, Hamada S, Becker M, et al. Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation. Heart. 2011;97:1578–84.CrossRefPubMed
Metadata
Title
Emergency transcatheter aortic valve replacement for a patient with decompensated severe aortic stenosis accompanied by cardiorenal syndrome: a case report
Authors
Hongju Kim
Jung-Hee Lee
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2018
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-018-0791-7

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