Case Studies in physiology: Cheyne-Stokes respiration and cardiovascular oscillations ending abruptly when deploying transfemoral aortic valve

David Kahn, Philippe Baele, Agnes Pasquet, Giuseppe Liistro
2019 Journal of applied physiology  
A 86 year-old gentleman was referred for trans-femoral aortic valve implantation. Transthoracic echocardiography revealed a severe stenosis (mean gradient 58 mmHg, aortic valve area: 0.4 cm2) and after multidisciplinary discussion, the risk of surgery was judged too high (logistic Euroscore: 51%) and the patient was proposed for a trans-femoral aortic valve implantation (TAVI). On arrival in the operating room the patient, fully conscious, was noted to have Cheyne-Stokes breathing (CSB),
more » ... ing after 40 % oxygen administration. TAVI procedure was successful and CSB pattern was interrupted within 8 seconds. 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.
doi:10.1152/japplphysiol.00193.2019 pmid:31873067 fatcat:6r7tjzwd6jf3zjvahiovhetjue