Key result
Placement of an Amplatz-type ASD occluder and a percutaneous LVAD successfully stabilized a patient with severe aortic regurgitation and cardiogenic shock as a bridge to surgical valve replacement.
Case Report (n=1)
Demonstrates the feasibility of using an ASD occluder and percutaneous LVAD to stabilize a patient with severe aortic regurgitation and cardiogenic shock as a bridge to surgery.
May support temporary stabilization in refractory severe AR shock; leaves open need for prospective validation.
Acute hemodynamic compromise due to severe aortic regurgitation remains a difficult problem. The optimal management strategy and timing of surgery continues to evolve as new technologies become available. Here, we report the case of a young woman presenting with severe regurgitation of an aortic homograft who developed precipitous cardiogenic shock and multi-organ dysfunction. Her mortality risk with emergent surgery was prohibitive, and no percutaneous valve-in-valve device was available. We stabilized her condition by placing an Amplatz-type Atrial Septal Defect (ASD) occluder across her aortic valve in conjunction with a percutaneous left ventricular assist device as a bridge to surgical valve replacement. She went on to a successful surgery and recovered well.
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Pollak et al. (2013) conducted a case report in Severe aortic regurgitation and cardiogenic shock (n=1). Amplatz-type Atrial Septal Defect (ASD) occluder and percutaneous left ventricular assist device was evaluated on Bridge to surgical valve replacement. Placement of an Amplatz-type ASD occluder and a percutaneous LVAD successfully stabilized a patient with severe aortic regurgitation and cardiogenic shock as a bridge to surgical valve replacement.
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