Emergency transcatheter aortic valve implantation in cardiogenic shock: a case report

Abstract

To the Editor, Transcatheter aortic valve implantation (TAVI) is a therapeutic alternative that has proven safe and effective across different clinical settings. Over the last few years, more and more cases of «emergency TAVI» have been reported.1-2 Currently, this term is often used for those implantation procedures performed during admission due to decompensated heart failure although this concept includes very different situations. The therapeutic option to treat cardiogenic shock should be «emergency TAVI», that is, implantation performed within the first 72 hours after admission.3 This is the case of a patient with severe aortic stenosis who was transferred to our center with signs of cardiogenic shock. This is the case of a 67-year-old man. The patient was a former smoker and a regular drinker. Initially, he had been admitted to a different center with early signs of heart failure. Arterial pressure at admission was 120/90 mmHg with global congestion and need for low-flow oxygen therapy. Diuretic treatment was started, and the echocardiogram revealed the presence of severe aortic stenosis with left systolic dysfunction. The patient had signs of liver (alanine aminotransferase, aspartate aminotransferase, and bilirubin levels of 1244 u/L, 1808 u/L, and 2 mg/dL, respectively, and normalized international ratio of 2), and...