Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation

Left ventricular outflow tract (LVOT) obstruction is sometimes observed in patients with severe aortic stenosis (AS). It is still controversial how to manage the remaining severe AS, when LVOT obstruction is well-controlled by medical therapy. We report a case with acute recurrence of LVOT obstructi...

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Main Authors: Hideki Kitahara, Kaoru Matsuura, Atsushi Sugiura, Akiko Yoshimura, Takahiro Muramatsu, Yusaku Tamura, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2018/5026190
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author Hideki Kitahara
Kaoru Matsuura
Atsushi Sugiura
Akiko Yoshimura
Takahiro Muramatsu
Yusaku Tamura
Takashi Nakayama
Yoshihide Fujimoto
Goro Matsumiya
Yoshio Kobayashi
author_facet Hideki Kitahara
Kaoru Matsuura
Atsushi Sugiura
Akiko Yoshimura
Takahiro Muramatsu
Yusaku Tamura
Takashi Nakayama
Yoshihide Fujimoto
Goro Matsumiya
Yoshio Kobayashi
author_sort Hideki Kitahara
collection DOAJ
description Left ventricular outflow tract (LVOT) obstruction is sometimes observed in patients with severe aortic stenosis (AS). It is still controversial how to manage the remaining severe AS, when LVOT obstruction is well-controlled by medical therapy. We report a case with acute recurrence of LVOT obstruction requiring emergent alcohol septal ablation (ASA) after transcatheter aortic valve implantation (TAVI), even in a stable state on beta-blockers. For the ASA procedure, transesophageal echocardiography was useful to clearly observe the perfusion area of the target septal branch by injecting microbubble contrast. Since it took some time to cause the recurrence of LVOT obstruction in this case, careful evaluation should be done after TAVI in high-risk patients for LVOT obstruction before terminating the TAVI procedure.
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issn 2090-6412
language English
publishDate 2018-01-01
publisher Wiley
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series Case Reports in Cardiology
spelling doaj-art-ccb7a55e44ee4668b52c6d38dedb435b2025-08-20T02:19:57ZengWileyCase Reports in Cardiology2090-64122018-01-01201810.1155/2018/50261905026190Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve ImplantationHideki Kitahara0Kaoru Matsuura1Atsushi Sugiura2Akiko Yoshimura3Takahiro Muramatsu4Yusaku Tamura5Takashi Nakayama6Yoshihide Fujimoto7Goro Matsumiya8Yoshio Kobayashi9Department of Cardiovascular MedicineDepartment of Cardiovascular SurgeryDepartment of Cardiovascular MedicineDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of Cardiovascular SurgeryDepartment of Cardiovascular MedicineDepartment of Cardiovascular MedicineDepartment of Cardiovascular SurgeryDepartment of Cardiovascular MedicineLeft ventricular outflow tract (LVOT) obstruction is sometimes observed in patients with severe aortic stenosis (AS). It is still controversial how to manage the remaining severe AS, when LVOT obstruction is well-controlled by medical therapy. We report a case with acute recurrence of LVOT obstruction requiring emergent alcohol septal ablation (ASA) after transcatheter aortic valve implantation (TAVI), even in a stable state on beta-blockers. For the ASA procedure, transesophageal echocardiography was useful to clearly observe the perfusion area of the target septal branch by injecting microbubble contrast. Since it took some time to cause the recurrence of LVOT obstruction in this case, careful evaluation should be done after TAVI in high-risk patients for LVOT obstruction before terminating the TAVI procedure.http://dx.doi.org/10.1155/2018/5026190
spellingShingle Hideki Kitahara
Kaoru Matsuura
Atsushi Sugiura
Akiko Yoshimura
Takahiro Muramatsu
Yusaku Tamura
Takashi Nakayama
Yoshihide Fujimoto
Goro Matsumiya
Yoshio Kobayashi
Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation
Case Reports in Cardiology
title Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation
title_full Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation
title_fullStr Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation
title_full_unstemmed Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation
title_short Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation
title_sort recurrence of left ventricular outflow tract obstruction requiring alcohol septal ablation after transcatheter aortic valve implantation
url http://dx.doi.org/10.1155/2018/5026190
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