Post-TAVR Suicide Left Ventricle

Pre-TAVR: High afterload from aortic stenosis leads to compensatory left ventricular hypertrophy and chronic pressure overload

Post-TAVR: Rapid ↓ in afterload can lead to ↑↑ contractility from the chronically hypertrophied LV → cavity obliteration

Treat like Hypertrophic Cardiomyopathy w/ Obstruction

   ✓ Ensure Adequate Preload

   ✓ Avoid Excessive Vasodilation

   ✓ Consider Phenylephrine to ↑ Afterload and ↓ Intra-Cavitary Gradients

   ✓ Continue Beta Blockers through TAVR: ↓ Inotropy + ↑ Diastolic Filling Time



- Cardionerds - Karan Desai MD, MPH @karanpdesai



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