Mitral valve perforation during transcatheter aortic valve replacement. (June 2020)

• Record Type: Journal Article
• Authors: Higa, Shotaro; Nagano, Takaaki; Yamashiro, Satoshi; Iwabuchi, Masashi
• Is Part Of: Asian cardiovascular & thoracic annals. Volume 28:Number 5(2020)
• Page Start: 276
• Page End: 278
• Publication Date: 2020-06
• Subjects: Aortic valve stenosis -- cardiac catheterization -- heart injuries -- heart valve prosthesis implantation -- mitral valve -- transcatheter aortic valve replacement; Heart -- Diseases -- Asia -- Periodicals; Heart -- Diseases -- Pacific Area -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Surgery -- Asia -- Periodicals; Heart -- Surgery -- Pacific Area -- Periodicals; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Asia -- Periodicals; Chest -- Surgery -- Pacific Area -- Periodicals; Chest -- Surgery -- Periodicals; 617.412
• DOI: 10.1177/0218492320930842
• Languages: English
• ISSNs: 0218-4923

Abstract

An 86-year-old female with severe aortic valve stenosis underwent transcatheter aortic valve replacement. A balloon-expandable valve was used, guided by a double-stiff guidewire that successfully straightened the aorta. During valve placement, the balloon shifted. After placement of the prosthetic valve, intraoperative transesophageal echocardiography revealed severe mitral regurgitation from the anterior mitral leaflet. Open conversion was performed immediately. A 5-mm hole was identified in the anterior leaflet, and direct closure was chosen for mitral valve repair. While transcatheter aortic valve replacement has gained popularity for patients with severe aortic stenosis and high operative risk, reports of mitral valve perforation are rare.