Pulmonary Hemorrhaging Caused by Acute Severe Mitral Regurgitation during Transcatheter Aortic Valve Implantation

• Published in: Internal Medicine Vol. 57; no. 8; pp. 1115 - 1117
• Main Authors: Higuchi, Ryosuke, Tobaru, Tetsuya, Saji, Mike, Mahara, Keitaro, Takamisawa, Itaru, Shimizu, Jun, Takanashi, Shuichiro, Takayama, Morimasa
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01-01-2018; Japan Science and Technology Agency
• Subjects: Aged, 80 and over; Aortic stenosis; Aortic valve; Aortic Valve - surgery; Aortic Valve Stenosis - surgery; Case Report; complication; Complications; Electrocardiography; Hemodynamics; Humans; Implantation; Internal medicine; Lung - blood supply; lung hemorrhage; Male; mitral regurgitation; Mitral Valve Insufficiency - complications; Mitral Valve Insufficiency - surgery; pulmonary hemorrhage; Regurgitation; Stenosis; transcatheter aortic valve implantation; Transcatheter Aortic Valve Replacement - adverse effects; Treatment Outcome; transcatheter aortic valve implantation; pulmonary hemorrhage; complication; mitral regurgitation; lung hemorrhage
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.9712-17

Transcatheter aortic valve implantation (TAVI) has been validated as a reliable therapy for aortic stenosis (AS), similar to surgical aortic valve replacement. Due to the methodological differences between the two therapeutic options, each has unique complications. We experienced a hitherto unreported complication of TAVI. An 81-year-old man underwent TAVI for severe AS. Acute mitral regurgitation (MR) occurred during valve deployment. Interference of the guidewire with the mitral subvalvular structure caused transient severe MR, leading to the development of pulmonary hemorrhaging. During TAVI, careful attention should be paid to the position of the guidewire, changes in hemodynamics and degree of MR.