Key result
Combined BAV and Impella in moderate AR triggers torrential regurgitation requiring bailout TAVI.
Why the study?
Severe aortic stenosis is a contraindication to the Impella pump, but balloon aortic valvuloplasty may facilitate pump implantation despite carrying a risk of significant aortic regurgitation.
What are the consequences of combined balloon aortic valvuloplasty and Impella implantation in a patient with pre-existing moderate aortic regurgitation?
Case Report (n=1)
What are the consequences of combined balloon aortic valvuloplasty and Impella implantation in a patient with pre-existing moderate aortic regurgitation?
Performing balloon aortic valvuloplasty to facilitate Impella implantation in patients with pre-existing moderate aortic regurgitation carries a high risk of inducing torrential aortic regurgitation that may require bailout TAVI.
May raise mortality if unmanaged; leaves open prospective validation of Impella use in balloon valvuloplasty for TAVI.
Severe aortic stenosis is a contraindication to the Impella pump (Abiomed Inc., Danvers, MA, US); however, clinical practice shows that balloon aortic valvuloplasty (BAV) may facilitate pump implantation [1-3].However, BAV carries a risk of significant aortic regurgitation (AR) and is therefore generally avoided in patients with AR.This case demonstrates consequences of combined BAV and Impella implantation in a patient with pre-existing moderate AR, highlighting associated risks and potential management strategies.
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Sacha et al. (2026) conducted a case report in Severe aortic stenosis with pre-existing moderate aortic regurgitation (n=1). Combined balloon aortic valvuloplasty (BAV) and Impella implantation was evaluated on Torrential aortic regurgitation requiring bailout TAVI. Combined balloon aortic valvuloplasty and Impella implantation in a patient with pre-existing moderate aortic regurgitation resulted in torrential aortic regurgitation requiring bailout TAVI.
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