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Vol. 31. Issue 2.
Pages 177-178 (February 2012)
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Vol. 31. Issue 2.
Pages 177-178 (February 2012)
Image in cardiology
DOI: 10.1016/j.repce.2012.01.005
Open Access
Echocardiographic findings of iatrogenic septal defect during TA-AVI
Achados ecocardiograficos de comunicação interventricular iatrogênica durante TA-AVI
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Paolo Giuseppe Pino, Amedeo Pergolini, Giordano Zampi
Corresponding author
giordano.zampi@alice.it

Corresponding author.
Department of Cardiovascular Science, “S. Camillo-Forlanini” Hospital, Rome, Italy
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Peri-procedural complications may occur in transapical aortic valve implantation (TA-AVI).

On intraoperative transesophageal echocardiography, after apical puncture, the valvuloplasty catheter impinged on the interventricular septum (Fig. 1, Video 1). When the catheter was pulled back, an iatrogenic ventricular septal defect (VSD) with a clear left-to-right shunt was detected (Fig. 2, Video 2). TA-AVI was then performed without any other complications. One year later the patient was asymptomatic and in good clinical condition. The VSD was confirmed by transthoracic echocardiography (Fig. 3, Video 3), with a Qp/Qs of 1.2.

Figure 1.

Intraoperative transesophageal echocardiography (TEE): valvuloplasty catheter impinging on the interventricular septum (white arrow).

(0.09MB).
Figure 2.

Intraoperative TEE: a clear left-to-right shunt was detected on color Doppler.

(0.1MB).
Figure 3.

Follow-up TTE: the VSD was still clear and patent.

(0.24MB).
Conflicts of interest

The authors have no conflicts of interest to declare.

Copyright © 2011. Sociedade Portuguesa de Cardiologia
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