Why the study?
Mitral valve perforation after TAVR is a seldom described but potentially serious complication associated with high early mortality that clinicians should be aware of.
Mitral valve perforation is a rare but potentially serious complication of TAVR that can present as severe mitral regurgitation and worsening heart failure months after the procedure.
Post-TAVR mitral perforation warrants vigilance given high early mortality with significant MR; this case report leaves open true incidence and prevention strategies.
Pre-procedure mitral regurgitation (MR) is a frequent coexistent finding in patients undergoing transcatheter aortic valve replacement (TAVR), and most of them (up to 55%) experience a significant improvement in MR after the procedure. Although seldom described, mitral valve perforation after TAVR is a potentially serious complication that physicians should be aware of, as moderate or severe MR in TAVR recipients is associated with a high early mortality rate. We herein describe the case of a 65-year-old man presenting with worsening heart failure symptoms 5 months after TAVR due to an intraprocedural anterior mitral leaflet perforation and discuss the diagnostic process and therapeutic course of the case. Furthermore, we draw attention to the essential role of echocardiography in the management of TAVR procedures, taking into account its ability in detecting early complications, and emphasize the value of CT as a main determinant to predict long-term MR improvement after TAVR and to assess the potential candidates for double valve repair with percutaneous techniques.
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Moldovan et al. (2022) studied this question.
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