Aorto-right ventricular fistula after transfemoral aortic valve

ArticleinThe Journal of invasive cardiology 22(2):E30-1 · February 2010with13 Reads
Source: PubMed
A 91-year-old female patient presented with worsening exertional dyspnea 1 month after transfemoral aortic valve implantation using an Edwards Sapien valve. She was found to have a paraprosthetic sinus of Valsalva rupture with a left-to-right shunt into the right ventricular cavity. The patient underwent coil closure of the defect with successful shunt elimination.
    • "Aortic dissection that had caused an aorto-right ventricular fistula has been also reported in the literature [5]. Recently, the formation of such a fistula as a complication of transcatheter aortic valve implantation has been reported, indicating erosion by the mechanical prosthetic valve struts as the possible mechanism for the fistula formation [6]. The clinical presentation of an aorto-right ventricular fistula depends on its etiology, as well as on the size of the shunt. "
    [Show abstract] [Hide abstract] ABSTRACT: The occurrence of aorto-right ventricular fistula after aortic valve replacement is rare. If remains untreated, the condition could result in heart failure and therefore significantly compromise patients’ survival. Surgical closure comprises the treatment of choice; however, transcatheter closure has been attempted, with relatively acceptable results. We report on a patient with an aorto-right ventricular fistula present for nine years, after aortic valve replacement, who presented with heart failure. Successful transcatheter closure of the fistula with the use of the Amplatzer duct occluder was performed, suggesting the percutaneous approach as an efficient technique for the treatment of such fistulae.
    Full-text · Article · Jun 2016
    • "The most common iatrogenic causes for ARV fistulas are aortic valve replacement and to a lesser degree type A aortic dissection repair [4,5]. Few cases have been reported post transfemoral aortic valve implanatation (TAVI) [6]. A well recognized rare cause of ARV fistula is rupture of sinus of valsalva aneurysms whether congenital or acquired [7]. "
    Full-text · Article · May 2016 · Hellenic Journal of Cardiology
    • "Indeed, ARV fistula may follow either surgical aortic valve replacement [1, 15] or percutaneous aortic valve implantation (TAVI) [16] . Several mechanisms may lead to cardiac shunts during aortic valve surgery including unintentional injury to the membranous septum sustained during dissection below the noncoronary cusps, perivalvular damage attributable to improper retraction and excessive and aggressive debridement of bulky areas of calcification from the aortic annulus567891011121314151617 and/or pseudo-aneurysm formation secondary to degenerative changes at the aortotomy line and the pseudo-aneurysm's eventual rupture into the RV [1] . Lorenz et al. proposed ischemic necrosis because of inappropriate suturing of the mechanical valve if the membranous portion of the ventricular septum is included in the prosthetic valve suture line [5] . "
    Full-text · Article · Dec 2015
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