Temporary worsening of mitral regurgitation due to conduction disturbance after transcatheter aortic valve implantation

BACKGROUND: Mitral regurgitation after transcatheter aortic valve implantation (TAVI) can be caused by various etiologies. CASE PRESENTATION: An 81-year-old woman with mild mitral regurgitation and complete right bundle branch block was scheduled to undergo TAVI under general anesthesia. After the deployment of the prosthetic valve, electrocardiography depicted a wide QRS wave and bradycardia, suggestive of complete atrioventricular block. Although there was no lesion indicative of tissue injury to the valve itself, worsening of mitral regurgitation was identified on transesophageal echocardiography. The hemodynamic condition was stable, and no additional procedure was performed. Electrocardiography depicted a return to a narrow QRS wave 3 days after surgery, and the mitral regurgitation appeared comparable to the preoperative grade. We assumed that the worsening of mitral regurgitation was caused by dyssynchrony in the left ventricle due to the conduction disorder. CONCLUSIONS: Mitral regurgitation after TAVI needs observation, including the determination of the etiology and treatment principle.