Emergency transcatheter aortic valve replacement for a patient with decompensated severe aortic stenosis accompanied by cardiorenal syndrome: a case report.

Kim, Hongju; Lee, Jung-Hee
BMC cardiovascular disorders
2018Mar ; 18 ( 1 ) :55.
저자 상세정보
Kim, Hongju - Division of Cardiology, Yeungnam University Medical Center, Yeungnam University College of Medicine, 3170, Hyeonchung-ro, Nam-gu, Daegu, South Korea.
Lee, Jung-Hee - Division of Cardiology, Yeungnam University Medical Center, Yeungnam University College of Medicine, 3170, Hyeonchung-ro, Nam-gu, Daegu, South Korea. seranflute@gmail.com.
ABSTRACT
BACKGROUND: Severe aortic stenosis (AS) may lead to acute decompensated heart failure resistant to medical treatment. Here, we report a successful emergent transcatheter aortic valve replacement (TAVR) in a patient presenting with decompensated severe AS accompanied by cardiorenal syndrome. CASE PRESENTATION: A 82-year-old man presented at our emergency department with aggravated dyspnea. His chest X-ray showed bilateral pulmonary edema, and laboratory examination revealed acute kidney injury. Transthoracic echocardiography (TTE) revealed low-flow, low-gradient AS with decreased left ventricular systolic function. With a diagnosis of acute decompensated heart failure combined with cardiorenal syndrome, we opted to perform emergent TAVR. Ultimately, we successfully performed emergent TAVR using only TTE and 3-D transesophageal echocardiography (TEE) measurements.

CONCLUSIONS: This report presents a case of decompensated severe AS accompanied by cardiorenal syndrome that was treated successfully with emergent TAVR. Thus, emergent TAVR using only echocardiography measurements is a feasible and safe option for treating decompensated heart failure accompanied by cardiorenal syndrome the clinical setting.
keyword
Cardiorenal syndrome; Heart failure; Transcatheter aortic valve replacement
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
The patient’s dyspnea was dramatically improved after the procedure, and chest X-ray showed marked improvement. The post-procedural TTE revealed improved LV systolic function (LV ejection fraction, 45%) with well-functioning CoreValve (aortic valve area of 2.15 cm2 based on the continuity equation and mean systolic pressure gradient of 3.22 mmHg). Urine output was also increased, creatinine level was decreased to 1.4 mg/dL, and eGFR increased to 52 mL/min/1.73 m2. He was discharged 7 days after the procedure.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
KCD코드
ICD 03
건강보험코드