High pacing rates for management of aortic insufficiency after balloon aortic valvuloplasty or transcatheter aortic valve replacement

Catheter Cardiovasc Interv. 2014 Jan 1;83(1):162-8. doi: 10.1002/ccd.24902. Epub 2013 Mar 25.

Abstract

Aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR) is difficult to manage when associated with congestive heart failure. AI after balloon aortic valvuloplasty (BAV) may be catastrophic, especially in patients who are not candidates for TAVR. We describe the use of urgent temporary pacing, followed by permanent pacing, to increase the heart rate to diminish diastolic filling time for the short term management of AI after BAV or TAVR. The strategy is particularly useful in patients who already have permanent pacemakers, which are common in this population.

Keywords: aortic regurgitation; aortic stenosis; paravalvular leak; valvuloplasty.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aorta / physiopathology
  • Aortic Valve Insufficiency / diagnosis
  • Aortic Valve Insufficiency / etiology
  • Aortic Valve Insufficiency / physiopathology
  • Aortic Valve Insufficiency / therapy*
  • Aortic Valve Stenosis / diagnosis
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / therapy*
  • Arterial Pressure
  • Balloon Valvuloplasty / adverse effects*
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / methods
  • Cardiac Pacing, Artificial / methods*
  • Electrocardiography
  • Female
  • Heart Rate
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Male
  • Treatment Outcome
  • Ventricular Function, Left
  • Ventricular Pressure