Key result
TAVI triggers acute pulmonary congestion and LVOT obstruction in severe LVH.
Why the study?
TAVI can be associated with dynamic hemodynamic complications in patients with marked left ventricular hypertrophy.
TAVI in patients with severe left ventricular hypertrophy can trigger dynamic hemodynamic complications, including LVOT obstruction and acute pulmonary congestion, necessitating cautious postoperative management.
Transcatheter aortic valve implantation (TAVI) may be associated with dynamic hemodynamic complications in patients with marked left ventricular hypertrophy. We report a rare case of acute pulmonary congestion caused by TAVI-induced left ventricular outflow tract obstruction with systolic anterior motion, severe mitral regurgitation, and markedly elevated left ventricular end-diastolic pressure. An 88-year-old woman developed severe hypotension and persistent systolic anterior motion immediately after TAVI, with a left ventricular end-diastolic pressure (LVEDP) of 35 mm Hg. Despite transient stabilization, pulmonary congestion occurred after extubation, requiring reintubation. This case underscores the importance of cautious postoperative management in high-risk patients.
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Yoshiga et al. (2026) studied this question. TAVI in an 88-year-old woman with severe left ventricular hypertrophy caused acute pulmonary congestion and left ventricular outflow tract obstruction with an LVEDP of 35 mm Hg.
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