Dysphagia following transcatheter mitral valve-in-ring replacement complicated by neo-left ventricular outflow tract obstruction: a case report

To our knowledge, this is the first case report of TMVR complicated by reversible neo-LVOT obstruction with only trivial paravalvular regurgitation causing intravascular haemolysis and subsequent dysphagia. The management of dysphagia secondary to intravascular haemolysis due to neo-LVOT obstruction is challenging. This is because of the complex haemodynamic interplay between reduced oral intake, a high output state with anaemia, increased ventricular contractility, tachycardia, and worsening dynamic obstruction, all part of a vicious cycle (<i>Summary figure</i>).