The following case report details an 88-year-old woman with severe mitral stenosis and moderate mitral regurgitation who presented with worsening dyspnea on exertion. The patient had undergone 4-vessel coronary artery bypass graft and mitral valve replacement 14 years before and was deemed high risk for redo sternotomy. A transseptal mitral valve-in-valve replacement was performed which resulted in intraoperative hypoxia and hypotension after atrial septal defect creation for valve deployment. A right-to-left shunt had developed due to the patient’s underlying pulmonary hypertension. Successful atrial septal defect closure resolved the hypoxia and hypotension. The patient had a brief and uncomplicated postoperative course.
From the Department of Anesthesiology, Ochsner Health Systems, New Orleans, Louisiana.
Accepted for publication August 10, 2018.
The authors declare no conflicts of interest.
Address correspondence to Ryan Latimer, MD, MSc, Department of Anesthesia, Ochsner Medical Center, 1514 Jefferson Hwy, New Orleans, LA 70121. Address e-mail to firstname.lastname@example.org.