Acute Pulmonary Congestion Secondary to Left Ventricular Outflow Tract Obstruction Following Transcatheter Aortic Valve Implantation in Severe Left Ventricular Hypertrophy: A Case Report

Transcatheter aortic valve implantation (TAVI) may be associated with dynamic hemodynamic complications in patients with marked left ventricular hypertrophy. We report a rare case of acute pulmonary congestion caused by TAVI-induced left ventricular outflow tract obstruction with systolic anterior motion, severe mitral regurgitation, and markedly elevated left ventricular end-diastolic pressure. An 88-year-old woman developed severe hypotension and persistent systolic anterior motion immediately after TAVI, with a left ventricular end-diastolic pressure (LVEDP) of 35 mm Hg. Despite transient stabilization, pulmonary congestion occurred after extubation, requiring reintubation. This case underscores the importance of cautious postoperative management in high-risk patients.