Mitral valve perforation after left lateral accessory pathway ablation: a case report.
Catheter ablation
Left lateral accessory pathway
Minithoracotomy
Mitral valve perforation
Mitral valve repair
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
07 Mar 2022
07 Mar 2022
Historique:
received:
05
11
2020
accepted:
01
11
2021
entrez:
8
3
2022
pubmed:
9
3
2022
medline:
11
3
2022
Statut:
epublish
Résumé
Radiofrequency catheter ablation is considered to be a relatively safe procedure. This is an unusual case report in which severe mitral regurgitation was occurred after left lateral accessory pathway radiofrequency catheter ablation. A 15-year-old man without structural heart disease was referred for ablation of a left lateral accessory pathway. He was a rugby player who had lived with Wolff-Parkinson-White syndrome since 2017. In 2017, two failed extensive radiofrequency catheter ablations of a left lateral accessory pathway had been performed in another center. In June 2018, he underwent a third radiofrequency catheter ablation of a left lateral accessory pathway using an anterograde transseptal approach with an early recurrence one month later. A successful fourth procedure was performed in August 2018 using a retrograde aortic approach. Three months later, the patient presented to the hospital with atypical chest pain and dyspnea on exertion. Transthoracic echocardiography revealed severe mitral regurgitation caused by a perforation of the posterior leaflet. Given the symptoms and the severity of the mitral valve regurgitation, the decision was taken to proceed with surgical intervention. Posterior mitral leaflet perforation was confirmed intraoperatively. The patient underwent video-assisted mitral valve repair via Minithoracotomy approach. This case demonstrates a very rare complication of Wolff-Parkinson-White radiofrequency ablation.
Sections du résumé
BACKGROUND
BACKGROUND
Radiofrequency catheter ablation is considered to be a relatively safe procedure. This is an unusual case report in which severe mitral regurgitation was occurred after left lateral accessory pathway radiofrequency catheter ablation.
CASE PRESENTATION
METHODS
A 15-year-old man without structural heart disease was referred for ablation of a left lateral accessory pathway. He was a rugby player who had lived with Wolff-Parkinson-White syndrome since 2017. In 2017, two failed extensive radiofrequency catheter ablations of a left lateral accessory pathway had been performed in another center. In June 2018, he underwent a third radiofrequency catheter ablation of a left lateral accessory pathway using an anterograde transseptal approach with an early recurrence one month later. A successful fourth procedure was performed in August 2018 using a retrograde aortic approach. Three months later, the patient presented to the hospital with atypical chest pain and dyspnea on exertion. Transthoracic echocardiography revealed severe mitral regurgitation caused by a perforation of the posterior leaflet. Given the symptoms and the severity of the mitral valve regurgitation, the decision was taken to proceed with surgical intervention. Posterior mitral leaflet perforation was confirmed intraoperatively. The patient underwent video-assisted mitral valve repair via Minithoracotomy approach.
CONCLUSION
CONCLUSIONS
This case demonstrates a very rare complication of Wolff-Parkinson-White radiofrequency ablation.
Identifiants
pubmed: 35255938
doi: 10.1186/s13019-021-01710-9
pii: 10.1186/s13019-021-01710-9
pmc: PMC8903660
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
30Informations de copyright
© 2022. The Author(s).
Références
Heart. 1999 Mar;81(3):292-6
pubmed: 10026355
Circulation. 2013 Jun 25;127(25):2551-2
pubmed: 23797742
Pediatr Cardiol. 2017 Oct;38(7):1426-1433
pubmed: 28711964