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Successfully Treated Nonocclusive Mesenteric Ischemia After Transcatheter Aortic Valve Replacement
Masahiko Noguchi1, Minoru Tabata2, Joji Ito2
1Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
The Annals of Thoracic Surgery
|January 23, 2017
Summary
A patient developed nonocclusive mesenteric ischemia after transcatheter aortic valve replacement. Vasospasm was treated successfully with intraarterial vasodilators, resolving the severe abdominal pain and elevated lactate levels.
Area of Science:
- Cardiology
- Vascular Surgery
- Gastroenterology
Background:
- Severe aortic stenosis necessitates intervention, with transcatheter aortic valve replacement (TAVR) being a common treatment.
- Post-TAVR complications can include vascular events, necessitating vigilant monitoring.
- Mesenteric ischemia, particularly nonocclusive mesenteric ischemia (NOMI), is a rare but serious complication.
Observation:
- An 80-year-old male, post-TAVR, presented with severe abdominal pain and elevated serum lactate 30 hours after the procedure.
- Initial presentation suggested potential complications despite hemodynamic stability.
Findings:
- Selective superior mesenteric artery angiography revealed significant vasospasm.
- Diagnosis of non-occlusive mesenteric ischemia was confirmed based on clinical presentation and angiography.
Implications:
- Non-occlusive mesenteric ischemia is a rare but serious complication post-TAVR.
- Early diagnosis and intra-arterial vasodilator infusion can effectively manage this condition.
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