Key result
A rare aorto-right ventricular fistula presenting with complete heart block was identified in an 82-year-old male five years after an initially uncomplicated transcatheter aortic valve replacement.
Why the study?
TAVR can lead to rare complications such as ventricular septal defects that may cause hemodynamic instability and require intervention.
Case Report (n=1)
No
Aorto-right ventricular fistula is a rare but significant late complication of TAVR that can present with complete heart block and may be managed conservatively if the patient is hemodynamically stable.
New-onset heart block years after TAVR may signal aorto-RV fistula; this case extends known complications but leaves open incidence and management data.
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure for treating aortic stenosis. However, it can lead to complications, such as ventricular septal defects (VSD). Although rare, these defects may result in hemodynamic instability and require intervention. An 82-year-old male with a history of Edwards SAPIEN TAVR and heart failure presented with dyspnea, fatigue, and complete heart block. An electrocardiogram showed a heart block, and a transesophageal echocardiogram revealed a mild paravalvular leak and an outlet VSD at the aortic annulus. Cardiac catheterization confirmed a Qp/Qs ratio of 1.68. After pacemaker implantation, the patient remained stable, and conservative management was pursued with outpatient follow-up. Aorto-right ventricular fistula is a rare late complication of TAVR. Clinicians should consider VSD in patients with complete heart block and a TAVR history, and regular echocardiographic surveillance may be warranted for symptomatic patients.
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Le et al. (2025) conducted a case report in Aorto-right ventricular fistula post-TAVR (n=1). Transcatheter aortic valve replacement (TAVR) was evaluated on Diagnosis of aorto-right ventricular fistula and complete heart block. A rare aorto-right ventricular fistula presenting with complete heart block was identified in an 82-year-old male five years after an initially uncomplicated transcatheter aortic valve replacement.
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