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Non-occlusive Mesenteric Ischemia Following Transcatheter Aortic Valve Replacement: A Case Report
George C Michalopoulos1, Viktoriya Bikeyeva1, Giovanni Paolella1
1Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, USA.
Cureus
|July 9, 2025
Summary
Non-occlusive mesenteric ischemia (NOMI) is a rare complication following transcatheter aortic valve replacement (TAVR). Patients with prior aortic aneurysm repair require special attention due to NOMI risk, potentially caused by reduced cardiac output during TAVR.
Area of Science:
- Cardiology
- Vascular Surgery
- Gastroenterology
Background:
- Transcatheter aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
- Non-occlusive mesenteric ischemia (NOMI) is a rare but serious complication post-TAVR.
- The pathogenesis of NOMI after TAVR remains poorly understood.
Observation:
- A 79-year-old female with a history of abdominal aortic aneurysm repair and thoracic aortic aneurysm underwent TAVR.
- The patient subsequently developed NOMI, leading to extensive bowel necrosis and mortality.
- This case underscores the potential risks in patients with prior endovascular interventions.
Findings:
- NOMI following TAVR is associated with significant morbidity and mortality.
- Existing mesenteric vascular disease may predispose patients to NOMI after TAVR.
- Reduced cardiac output from rapid pacing during TAVR may exacerbate splanchnic hypoperfusion.
Implications:
- Increased vigilance is required for patients with a history of endovascular interventions undergoing TAVR.
- Further research into the specific mechanisms of NOMI post-TAVR is warranted.
- Consideration of hemodynamic changes during TAVR is crucial in at-risk populations.
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