Non-occlusive Mesenteric Ischemia Following Transcatheter Aortic Valve Replacement: A Case Report

Non-occlusive mesenteric ischemia (NOMI) is a rare complication after transcatheter aortic valve replacement (TAVR), with a poorly understood pathogenesis. We present the case of a 79-year-old female with a history of surgically repaired abdominal aortic aneurysm (AAA) and stable thoracic aortic aneurysm (TAA) who developed NOMI after TAVR, resulting in extensive bowel necrosis and patient mortality. Our case highlights the special attention that must be paid to patients with a history of endovascular interventions prior to TAVR due to the risk of postprocedural NOMI. We propose that NOMI after TAVR occurs from the reduction in cardiac output due to rapid pacing during valve deployment, resulting in worsening splanchnic hypoperfusion in patients with existing mesenteric vascular disease.