Mitral Valve Stenosis after Transcatheter Aortic Valve Replacement: Case Report and Review of the Literature
Highlights
- • TAVR is an effective and safer alternative to open heart surgery, but still bears risk for dangerous complications
- • Increased transmitral gradients after TAVR is a worrying finding, whose clinical relevance and management are not defined
- • Risk factors are to be searched into the complex interaction and coupling between mitral and aortic valves
- • Multi-modality imaging is fundamental to detect this complication and its consequences and to drive the treatment
- • The management should be based on the symptoms, hemodynamic conditions and feasibility of interventional techniques
Abstract
Mitral stenosis is a rare and potentially severe complication of transcatheter aortic valve replacement (TAVR). Given the anatomic coupling and interdependence of the aortic and mitral valves, it comes by itself that procedures (either surgical or percutaneous) involving the aortic valve imply the risk of altering mitral valve function. Indeed, transcatheter aortic prostheses may impair adequate anterior mitral leaflet (AML) opening, especially when implanted in a “low” position, thus resulting in high transvalvular gradients.