• A&A practice · Apr 2019

    Case Reports

    Right-to-Left Shunt During Transseptal Mitral Valve-in-Valve Replacement: A Case Report.

    • Ryan Latimer and George Gilly.
    • From the Department of Anesthesiology, Ochsner Health Systems, New Orleans, Louisiana.
    • A A Pract. 2019 Apr 1; 12 (7): 226-230.

    AbstractThe following case report details an 88-year-old woman with severe mitral stenosis and moderate mitral regurgitation who presented with worsening dyspnea on exertion. The patient had undergone 4-vessel coronary artery bypass graft and mitral valve replacement 14 years before and was deemed high risk for redo sternotomy. A transseptal mitral valve-in-valve replacement was performed which resulted in intraoperative hypoxia and hypotension after atrial septal defect creation for valve deployment. A right-to-left shunt had developed due to the patient's underlying pulmonary hypertension. Successful atrial septal defect closure resolved the hypoxia and hypotension. The patient had a brief and uncomplicated postoperative course.

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