How did i manage a case of pulseless electrical activity during transcatheter aortic valve implantation in a patient with severe aortic valve stenosis with left ventricular dysfunction?

Abstract

Cardiac arrest during transcatheter aortic valve implantation (TAVI) is rare but is generally associated with dramatic consequences including mortality and severe neurological damage. Our patient is an 89-year-old male with symptomatic severe aortic valve stenosis and left ventricular dysfunction. He had a prolonged cardiac arrest in the form of pulseless electrical activity (PEA) during TAVI. After ruling out cardiac tamponade and bleeding, we decided to do the TAVI while doing cardiopulmonary resuscitation. The hemodynamics of the patient improved immediately after TAVI and we could avoid the use of a mechanical circulatory support. We have also discussed in detail the cause, diagnosis, and management of PEA during TAVI.

Keywords

• aortic stenosis
• pulseless electrical activity
• transcatheter aortic valve implant