Aorto-right ventricular fistula following transcatheter aortic valve implantation using a 29 mm SAPIEN XT valve

An 83-year-old man with severe symptomatic aortic valve stenosis underwent transcatheter aortic valve implantation (TAVI) using a 29 mm SAPIEN XT valve. He was haemodynamically stable, but developed haemolytic anaemia. Transthoracic echocardiography conducted 7 days after TAVI revealed an abnormal continuous flow from the right sinus of Valsalva adjacent to the implanted valve to the right ventricle. The amount of shunt flow was considered small and the patient was managed with diuretics successfully. He was discharged from the hospital 35 days after TAVI. He was doing well at 9 months after TAVI, despite persistence of the aorto-right ventricular fistula on repeat echocardiographic examinations.

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