Alcohol septal ablation after transaortic valve implantation: the dynamic nature of left outflow tract obstruction.
Transcatheter aortic valve implantation (TAVI) has emerged as a less invasive and potentially high efficacious procedure for the treatment of high-risk patients with symptomatic aortic stenosis. Appropriate patient selection for TAVI is a key component to ultimate clinical success. Herein, we describe a patient with left ventricular outflow tract (LVOT) obstruction that became apparent only following relief of aortic stenosis with TAVI. This report highlights the dynamic nature of LVOT obstruction, which was successfully treated in our patient with catheter-based alcohol septal ablation. The potential to unmask dynamic LVOT obstruction with TAVI should be an important consideration in patient selection for the procedure, and the postoperative assessment of these patients.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA. sorajja.paul@mayo.edu
Paul
P
Sorajja
Jeff D
JD
Booker
Charanjit S
CS
Rihal
D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation; D015150:Echocardiography, Doppler; D000431:Ethanol / Q000008:administration & dosage*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D018579:Patient Selection; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014694:Ventricular Outflow Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
D000431:Ethanol