Key result
TAVI precipitates dynamic intraventricular gradients and suicide left ventricle in severe LV hypertrophy.
Why the study?
Patients with aortic stenosis and left ventricular hypertrophy from chronic pressure overload may develop dynamic intraventricular gradients and are at risk for hemodynamic aberrations and suicide left ventricle when undergoing TAVI.
Case Report (n=1)
Post-TAVI vigilance for suicide left ventricle may be warranted in severe LVH; leaves open optimal risk stratification and prevention strategies.
In some patients with aortic stenosis, dynamic intraventricular gradients like those seen in hypertrophic obstructive cardiomyopathy may develop secondary to left ventricular hypertrophy from chronic pressure overload. With the advent of transcatheter aortic valve implantation, many patients with aortic stenosis and advanced age who formerly would be considered "too high risk" for aortic valve replacement are getting treatment for their aortic stenosis. This case highlights the hemodynamic aberrations that can occur with TAVI leading to a cautionary note regarding implementation of this rapidly emerging technique in patients with left ventricles that may be at risk for suicide left ventricle.
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Suh et al. (2010) conducted a case report in Aortic stenosis with left ventricular hypertrophy (n=1). Transcatheter aortic valve implantation (TAVI) was evaluated on Hemodynamic aberrations / suicide left ventricle. Transcatheter aortic valve implantation in a patient with aortic stenosis and chronic pressure overload-induced hypertrophy precipitated dynamic intraventricular gradients and suicide left ventricle.
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