Post-TAVR: Suicide Left Ventricle
High afterload from aortic stenosis leads to compensatory left ventricular hypertrophy and chronic pressure overload. After TAVR, rapid reduction in afterload can lead to increased contractility from the chronically hypertrophied LV, resulting in cavity obliteration.
Treatment Approach: Treat Like Hypertrophic Cardiomyopathy with Obstruction
- Ensure adequate preload
- Avoid excessive vasodilation
- Consider phenylephrine to increase afterload and reduce intra-cavitary gradients
- Continue beta blockers through TAVR to decrease inotropy and increase diastolic filling time
Produced by: Dr. Evelyn Song | Dr. Karan Desai
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