Problem of small left ventricular volume during transcatheter aortic valve replacement: a case series
https://doi.org/10.15829/1560-4071-2025-6043
EDN: FCZVMU
Abstract
Modern treatment of severe aortic valve stenosis includes not only open surgery, but also minimally invasive transcatheter aortic valve implantation (TAVI). However, despite the reduction of periprocedural complications of TAVI with increasing experience of operators, the problem of interventions in patients with small left ventricular volume remains unclear.
It is known that with the progression of aortic stenosis, the left ventricle can undergo concentric remodeling with myocardial hypertrophy, which leads not only to a decrease in stroke volume, but also diastolic dysfunction due to increased wall stiffness. As a result, such a left ventricular phenotype, especially in combination with high pulmonary hypertension, is poorly resistant to hemodynamic overload, which carries an increased risk of intraoperative mortality. In our work, we present 3 cases of TAVI in similar patients with a small left ventricular volume, in which various modifications of the intervention algorithms were used.
About the Authors
A. A. Prokhorikhin
Almazov National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
none
Yu. V. Kukushkina
Almazov National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
none
D. D. Zubarev
Almazov National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
none
A. V. Gorbatykh
Almazov National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
none
K. B. Lapshin
Almazov National Medical Research Center
Russian Federation
Competing Interests:
Russian Federation
St. Petersburg
Competing Interests:
none
References
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Supplementary files
- Various strategies for transcatheter aortic valve implantation (TAVI) in patients with small left ventricular volume are presented.
- A change in the order and degree of balloon valvuloplasty is proposed to prevent left ventricular volume overload.
- Various patient management strategies can be used as guidelines for TAVI modification.
Review
For citations:
Prokhorikhin A.A., Kukushkina Yu.V., Zubarev D.D., Gorbatykh A.V., Lapshin K.B. Problem of small left ventricular volume during transcatheter aortic valve replacement: a case series. Russian Journal of Cardiology. 2025;30(10S):6043. (In Russ.) https://doi.org/10.15829/1560-4071-2025-6043. EDN: FCZVMU
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