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A rare delayed complication after TAVR: Acute severe aortic insufficiency
Ali Fatehi Hassanabad1, Angela Kealey2, Douglas D Seal3
1Section of Cardiac Surgery, Libin Cardiovascular Institute, Calgary, Canada.
Journal of Cardiac Surgery
|September 8, 2022
Summary
Transcatheter aortic valve replacement (TAVR) can lead to aortic regurgitation (AR) years later. This case highlights severe AR occurring 5 years post-TAVR with an Evolut R valve, presenting as heart failure.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Transcatheter aortic valve replacement (TAVR) is a standard treatment for severe aortic stenosis (AS) in high-risk patients.
- While TAVR offers favorable outcomes, complications like aortic regurgitation (AR) can occur post-procedure.
- Post-TAVR AR may manifest as paravalvular leak, central leak, or mixed patterns, potentially presenting at any time.
Observation:
- A patient presented with heart failure symptoms.
- Imaging revealed severe aortic regurgitation (AR).
- The patient had undergone TAVR 5 years prior using an Evolut R prosthetic valve.
Findings:
- The severe AR was found to be a complication occurring 5 years after the initial TAVR procedure.
- This late presentation of AR is considered unique and atypical.
- The specific prosthetic valve used was an Evolut R.
Implications:
- This case underscores the importance of long-term monitoring for AR after TAVR.
- It highlights the potential for late-onset AR, even with advanced prosthetic valves.
- Understanding atypical presentations of post-TAVR AR is crucial for timely diagnosis and management.
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