Dynamic left ventricular outflow tract obstruction complicating aortic valve replacement: a hidden malefactor revisited

It is known that a dynamic left ventricular outflow tract [LVOT] obstruction exists in patients, following aortic valve replacement [AVR] and is usually considered to be benign. We present a patient with dynamic LVOT obstruction following AVR, who developed refractory cardiogenic shock and expired inspite of various treatment strategies. This phenomenon must be diagnosed early and should be considered as a serious and potentially fatal complication following AVR. The possible mechanisms and treatment options are reviewed