Korean J Anesthesiol.  2013 Apr;64(4):360-362. 10.4097/kjae.2013.64.4.360.

Unexpected and fatal hemodynamic collapse during transapical transcatheter aortic valve implantation: A case report

• Kim EH
• Lee SM
• Lee JH
• Lee SH
• Park PW
• Gwon HC

• KMID: 2299375
• DOI: http://doi.org/10.4097/kjae.2013.64.4.360

Abstract

Although transcatheter aortic valve implantation (TAVI) is generally accepted as an alternative or promising treatment option for patients with decompensated cardiovascular disease in an inoperable or high-risk condition, severe hypotension and/or arrhythmia associated with rapid ventricular pacing still poses a challenge to many clinicians. This report describes a 79-year-old patient who experienced fatal hemodynamic collapse, which suddenly developed after a rapid ventricular pacing in spite of pre-administration of vasopressor. The procedure and anesthesia were uneventful until the first rapid ventricular pacing was applied. Following rapid ventricular pacing, his cardiovascular state was severely compromised and could not be recovered. Despite early initiation of extracorporeal membrane oxygenation device and supportive care, he died from heart failure on post-procedure day four.

Keyword

Heart failure; Hemodynamic collapse; Rapid ventricular pacing; Transcatheter aortic valve implantation

MeSH Terms

Anesthesia
Aortic Valve
Arrhythmias, Cardiac
Cardiovascular Diseases
Extracorporeal Membrane Oxygenation
Heart Failure
Hemodynamics
Humans
Hypotension