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Papillary muscle rupture after transcatheter aortic valve implantation

Yusuke Morita1, Akihiro Endo1, Kazuaki Tanabe1

  • 1Division of Cardiology, Shimane University Faculty of Medicine, Izumo, Japan.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 23, 2020
PubMed

Insights

Transcatheter aortic valve implantation (TAVI) can lead to fatal mitral regurgitation (MR) from papillary muscle rupture. This case highlights a severe MR complication occurring months after TAVI in an elderly patient.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter aortic valve implantation (TAVI) is a common procedure for severe aortic stenosis.
  • Catheter-induced complications, including mitral regurgitation (MR), can occur post-TAVI.
  • Mitral papillary muscle rupture is a rare but severe complication of TAVI.

Observation:

  • An 89-year-old male with symptomatic severe aortic stenosis underwent TAVI.
  • Preoperative echocardiography revealed accessory mitral valve tissue.
  • Moderate MR was noted immediately post-TAVI, progressing to severe MR due to anterolateral papillary muscle rupture at 3 months.

Findings:

  • The case demonstrates a delayed severe mitral regurgitation secondary to papillary muscle rupture following TAVI.
  • Accessory mitral valve tissue may be a contributing factor in catheter-induced MR.
  • Papillary muscle rupture can manifest several months after the TAVI procedure.

Implications:

  • This case underscores the importance of vigilant monitoring for delayed complications after TAVI.
  • Understanding risk factors like accessory mitral valve tissue is crucial for patient selection and management.
  • Further case reports are needed to elucidate the incidence and management of this rare TAVI complication.
Keywords:
accessory mitral valve issuemitral regurgitationtranscatheter valve implantationtransfemoral

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