Suicide left ventricle following transcatheter aortic valve implantation^†

In some patients with aortic stenosis, dynamic intraventricular gradients like those seen in hypertrophic obstructive cardiomyopathy may develop secondary to left ventricular hypertrophy from chronic pressure overload. With the advent of transcatheter aortic valve implantation, many patients with aortic stenosis and advanced age who formerly would be considered “too high risk” for aortic valve replacement are getting treatment for their aortic stenosis. This case highlights the hemodynamic aberrations that can occur with TAVI leading to a cautionary note regarding implementation of this rapidly emerging technique in patients with left ventricles that may be at risk for suicide left ventricle. © 2010 Wiley-Liss, Inc.