Cheyne-Stokes respiration and cardiovascular oscillations ending abruptly when deploying transfemoral aortic valve.
(2020) Journal of Applied Physiology — Vol. 128, n° 2, p. 345-349 (2020)
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- Abstract
- A 86-yr-old man was referred for transfemoral aortic valve implantation. Transthoracic echocardiography revealed a severe stenosis (mean gradient: 58 mmHg, aortic valve area: 0.4 cm), and after multidisciplinary discussion, the risk of surgery was judged too high (logistic Euroscore: 51%), and the patient was proposed for a transfemoral aortic valve implantation (TAVI). On arrival in the operating room, the patient, fully conscious, was noted to have Cheyne-Stokes breathing (CSB), which persisted after 40% oxygen administration. TAVI procedure was successful, and the CSB pattern was interrupted within 8 s. To the best of our knowledge, this report is the first to show an acute disappearance of CSB, occurring only seconds after TAVI and restoration of a normal hemodynamic situation. To explain such rapid changes in breathing pattern, we hypothesize a role played by the acute release of pulmonary hypertension and pulmonary volume overload. NEW & NOTEWORTHY Acute disappearance of Cheyne-Stokes breathing after transfemoral aortic valve implantation suggests a reflex pathway originating from the fall in pulmonary vessels congestion.
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Kahn, D., Baele, P., Pasquet, A., & Liistro, G. (2020). Cheyne-Stokes respiration and cardiovascular oscillations ending abruptly when deploying transfemoral aortic valve. Journal of Applied Physiology, 128(2), 345-349. https://doi.org/10.1152/japplphysiol.00193.2019 (Original work published 2020)