Mitral valve replacement complicated by iatrogenic left ventricular outflow obstruction and paravalvular leak: case report and review of literature

Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement. We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral...

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Bibliographic Details
Published in:BMC cardiovascular disorders 2015-10, Vol.15 (1), p.119-119, Article 119
Main Authors: Lee, Justin Z, Tey, Kai R, Mizyed, Ahmad, Hennemeyer, Charles T, Janardhanan, Rajesh, Lotun, Kapildeo
Format: Article
Language:English
Subjects:
Ablation Techniques
Aged
Albumin
Aortic Valve - surgery
Aortic Valve Insufficiency - surgery
Case Report
Female
Health aspects
Heart Valve Prosthesis Implantation - adverse effects
Humans
Iatrogenic Disease
Medical errors
Mitral Valve - surgery
Mitral Valve Insufficiency - surgery
Prosthesis Failure - etiology
Proteins - therapeutic use
Septal Occluder Device
Ventricular Outflow Obstruction - etiology
Ventricular Outflow Obstruction - surgery
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Summary:Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement. We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). We also describe the use of alcohol septal ablation and albumin-glutaraldehyde (BioGlue) for septal ablation to percutaneously treat the patient's LVOT obstruction, followed by use of an Amplatzer vascular plug for percutaneous closure of an antero-medial mitral PVL associated with severe regurgitation. Percutaneous interventional management of these entities may be considered as an initial therapeutic option, especially in high-risk patients with significant morbidity and mortality of repeat surgical operations.
ISSN:1471-2261
1471-2261
DOI:10.1186/s12872-015-0108-z