Ventricular tachycardia: ominous sign of devastating prosthetic aortic valve dehiscence

Prosthetic valve endocarditis (PVE) is the most feared complication after valve implantation. It usually results in substantial morbidity and mortality in the postoperative period. An adverse effect on the annulus can cause conduction disturbances in the atrioventricular (AV) node, resulting in a hi...

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Bibliographic Details
Published in:Annals of Saudi medicine 2015-11, Vol.35 (6), p.472-474
Main Authors: Sicaja, Mario, Baric, Davor, Unic, Daniel, Marusic, Srecko, Vincelj, Josip, Sicaja, Maria Nicole, Starcevic, Boris
Format: Article
Language:English
Subjects:
Aortic Valve - surgery
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Case Report
Coronary vessels
Electrocardiography
Endocarditis
Endocarditis, Bacterial - complications
Endocarditis, Bacterial - diagnosis
Endocarditis, Bacterial - etiology
Family medical history
Heart attacks
Heart failure
Heart surgery
Heart Valve Prosthesis - adverse effects
Heart Valve Prosthesis Implantation
Hospitals
Humans
Laboratories
Male
Middle Aged
Mortality
Prostheses
Prosthesis Failure
Surgical outcomes
Tachycardia, Ventricular - diagnosis
Tachycardia, Ventricular - etiology
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Summary:Prosthetic valve endocarditis (PVE) is the most feared complication after valve implantation. It usually results in substantial morbidity and mortality in the postoperative period. An adverse effect on the annulus can cause conduction disturbances in the atrioventricular (AV) node, resulting in a high-degree AV block. This study describes a case of PVE that predominantly presented with sustained monomorphic ventricular tachycardia, which indicated a severe clinical course of PVE caused by a significant displacement of the aortic valve prosthesis. In our opinion, a very pronounced flap valve motion of the dehisced valve probably caused, in the critical moment, coronary artery blood flow limitation by means of coronary microembolization, which produced temporary ischemia and provoked sustained ventricular tachycardia. Furthermore, disturbances of rhythm such as ventricular tachycardia in the setting of endocarditis indicate a high-risk condition and should mandate fast and thorough noninvasive diagnostic procedures to obtain correct diagnosis even in the case of mild, slowly progressing disease.
ISSN:0256-4947
0975-4466
DOI:10.5144/0256-4947.2015.472