Recurrent ventricular tachycardia managed with balloon aortic valvuloplasty: An unusual presentation of severe aortic stenosis

Abstract

A 68-year-old woman was transferred from a regional hospital with recurrent polymorphic ventricular tachycardia associated with haemodynamic instability. A diagnosis of severe aortic stenosis (AS) with normal left ventricular systolic function had recently been established on echocardiography. Correction of hypokalaemia and intravenous amiodarone infusion were ineffective. On transfer, ongoing ventricular arrhythmias requiring repeat defibrillation occurred. Urgent coronary angiography was unremarkable. Following consultation with the cardiosurgical team, emergency bridging balloon aortic valvuloplasty (BAV) was performed. Two weeks later the patient proceeded to an uneventful inpatient surgical aortic valve replacement (AVR). This case highlights an unusual presentation of severe AS, and describes the use of emergency BAV to correct arrhythmia-induced haemodynamic instability prior to surgical AVR. Copyright 2014 BMJ Publishing Group. All rights reserved. For.