Impact of VA-ECMO on Dynamic LV Outflow Obstruction After Transcatheter Aortic Valve Replacement

Juan Torrado, MD, PhD; Diego Barzallo, MD; Juan A. Terré, MD; César Joel Benites-Moya, MD; Saúl Ríos, MD; Mario García, MD; Mei Chau, MD; José M. Wiley, MD, MPH; Azeem Latib, MD

JACC: Case Reports (Jan 2024)

Impact of VA-ECMO on Dynamic LV Outflow Obstruction After Transcatheter Aortic Valve Replacement

Juan Torrado, MD, PhD,
Diego Barzallo, MD,
Juan A. Terré, MD,
César Joel Benites-Moya, MD,
Saúl Ríos, MD,
Mario García, MD,
Mei Chau, MD,
José M. Wiley, MD, MPH,
Azeem Latib, MD

Affiliations

Juan Torrado, MD, PhD: Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA; Address for correspondence: Dr Juan Torrado, Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, 1825 Eastchester Road, Bronx, New York 10461, USA.
Diego Barzallo, MD: Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
Juan A. Terré, MD: Department of Medicine, Section of Cardiology, Tulane University, New Orleans, Louisiana, USA
César Joel Benites-Moya, MD: Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
Saúl Ríos, MD: Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
Mario García, MD: Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
Mei Chau, MD: Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
José M. Wiley, MD, MPH: Department of Medicine, Section of Cardiology, Tulane University, New Orleans, Louisiana, USA
Azeem Latib, MD: Department of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA

Journal volume & issue: Vol. 29, no. 2
p. 102157

Abstract

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Dynamic left ventricular outflow obstruction is a rare but severe complication of transcatheter aortic valve replacement. It presents as a paradoxical hemodynamic collapse after relieving the left ventricular afterload. Considering its unique pathophysiology, this entity dictates counterintuitive treatments. We describe a case of left ventricular outflow obstruction treated with venoarterial extracorporeal membrane oxygenation and discuss its management principles. (Level of Difficulty: Intermediate.)

Published in JACC: Case Reports

ISSN: 2666-0849 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/jacc-case-reports

About the journal

Abstract

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