Key result
Transfemoral TAVR resolves severe AR without complications in an LVAD patient with a small aortic annulus.
Why the study?
Does transcatheter aortic valve replacement (TAVR) safely resolve severe aortic regurgitation in a patient with a left ventricular assist device and a small aortic annulus?
Case Report (n=1)
Does transcatheter aortic valve replacement (TAVR) safely resolve severe aortic regurgitation in a patient with a left ventricular assist device and a small aortic annulus?
TAVR using a self-expanding valve is feasible and safe for treating severe aortic regurgitation in an LVAD recipient with a small aortic annulus when meticulous planning and intraoperative management are employed.
Hypothesis-generating for TAVR in LVAD patients with severe AR and small annuli; prospective trials needed before clinical adoption.
We report the case of a 72-year-old woman with a HeartMate III left ventricular assist device who developed severe aortic regurgitation and New York Heart Association Class III symptoms. Given her high surgical risk and the presence of a small aortic annulus (mean diameter 18.4 mm), transfemoral transcatheter aortic valve replacement was performed using a 26-mm Evolut PRO+ self-expanding valve under transesophageal echocardiographic guidance. Temporary reduction of left ventricular assist device (LVAD) speed prevented ventricular migration during deployment. The procedure resulted in complete resolution of regurgitation without complications. This case demonstrates the feasibility and safety of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic regurgitation in patients with LVADs and small annuli, when meticulous pre-procedural planning and careful intraoperative management are employed.
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Keskin et al. (2026) conducted a case report in Severe aortic regurgitation (n=1). Transfemoral transcatheter aortic valve replacement (TAVR) using a 26-mm Evolut PRO+ self-expanding valve was evaluated on Resolution of regurgitation and procedural complications. Transfemoral TAVR using a 26-mm Evolut PRO+ valve successfully achieved complete resolution of severe aortic regurgitation without complications in a patient with an LVAD and small aortic annulus.
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