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Søren Rønborg1, Nis Høst1, Gintautas Bieliauskas2

  • 1Kardiologisk Afdeling, Københavns Universitetshospital - Bispebjerg og Frederiksberg Hospital.

Ugeskrift for Laeger
|February 10, 2023
PubMed
Summary

A rare aortic-to-right ventricle fistula complication after transcatheter aortic valve implantation (TAVI) led to a fatal outcome. This case highlights the critical need for early diagnosis of this severe TAVI complication.

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Transcatheter aortic valve implantation (TAVI) is a common procedure for aortic stenosis.
  • Rare complications can arise post-TAVI, necessitating vigilant monitoring.
  • Aortic-to-right ventricle fistula is an exceptionally uncommon sequela.

Observation:

  • An 87-year-old male presented with congestion six weeks post-TAVI.
  • The patient rapidly deteriorated with severe pain, elevated D-dimer, acidosis, and renal failure.
  • Transthoracic echocardiography identified a progressive aortic-to-right ventricle fistula.

Findings:

  • The fistula was present since the initial TAVI procedure.
  • Despite supportive care, the patient's condition worsened.
  • The patient ultimately succumbed to the complication.

Implications:

  • This case underscores the importance of considering rare fistulas after TAVI.
  • Early detection and management strategies for TAVI-related fistulas require further investigation.
  • Improved diagnostic protocols may enhance outcomes for patients with this rare complication.

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