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

BMC Cardiovasc Disord. 2015 Oct 9:15:119. doi: 10.1186/s12872-015-0108-z.

Abstract

Background: Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement.

Case presentation: 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.

Conclusion: 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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Ablation Techniques
  • Aged
  • Aortic Valve / surgery
  • Aortic Valve Insufficiency / surgery*
  • Female
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Humans
  • Iatrogenic Disease
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency / surgery*
  • Prosthesis Failure / etiology*
  • Proteins / therapeutic use
  • Septal Occluder Device
  • Ventricular Outflow Obstruction / etiology*
  • Ventricular Outflow Obstruction / surgery

Substances

  • Bio-glue
  • Proteins