Critical exacerbation of idiopathic pulmonary fibrosis after transcatheter aortic valve implantation: Need for multidisciplinary care beyond "heart team". Issue 5 (November 2018)

• Record Type: Journal Article
• Authors: Sugizaki, Yoichiro; Mori, Shumpei; Nagamatsu, Yuichi; Akita, Tomomi; Nagasawa, Akira; Toba, Takayoshi; Yamamoto, Masatsugu; Nishii, Tatsuya; Obata, Norihiko; Nomura, Yoshikatsu; Otake, Hiromasa; Shinke, Toshiro; Okita, Yutaka; Hirata, Ken-ichi
• Is Part Of: Journal of cardiology cases. Volume 18:Issue 5(2018)
• Page Start: 171
• Page End: 174
• Publication Date: 2018-11
• Subjects: Aortic stenosis -- General anesthesia -- Idiopathic pulmonary fibrosis -- Transcatheter aortic valve implantation; Cardiology -- Periodicals; Cardiovascular Diseases -- Case Reports; Cardiovascular Diseases -- Periodicals; Cardiology -- Case Reports; Cardiology -- Periodicals; Cardiology; Electronic journals; Periodicals; 616.12
• DOI: 10.1016/j.jccase.2018.07.005
• Languages: English
• ISSNs: 1878-5409

Abstract

Abstract: An 82-year-old man with severe aortic stenosis and idiopathic pulmonary fibrosis (IPF) underwent transcatheter aortic valve implantation (TAVI) under general anesthesia. However, following a successful TAVI procedure, he developed progressive respiratory failure because of the exacerbation of IPF. Despite the use of immunosuppressants, the patient could not be saved and he died of respiratory failure. Although TAVI is a less invasive procedure compared to conventional surgical aortic valve replacement, it is currently selected for management of severely ill, frail, and elderly patients. This case highlights the potential risk of IPF exacerbation following a TAVI procedure performed under general anesthesia. <Learning objective: Transcatheter aortic valve implantation (TAVI) procedures have been increasingly performed for high-risk patients, including those with high frailty and pulmonary dysfunction. Although TAVI is less invasive compared to open surgery, it may cause critical exacerbation of idiopathic pulmonary fibrosis when performed under general anesthesia. Multidisciplinary care beyond "heart team" would be necessary for prevention, as well as for detecting the early signs of exacerbation of idiopathic pulmonary fibrosis.>