Why the study?
Can v-a-ECMO be used as a bridge to TAVR in a patient with severe aortic stenosis, coronary artery disease, and cardiogenic shock?
Case Report (n=1)
No
Can v-a-ECMO be used as a bridge to TAVR in a patient with severe aortic stenosis, coronary artery disease, and cardiogenic shock?
Answers are grounded in this paper and cite their sources.
v-a-ECMO can serve as an effective emergency stabilization strategy and bridge to TAVR in very high-risk patients with severe aortic stenosis and cardiogenic shock.
BACKGROUND: Patients with severe aortic stenosis (AS) often present with multiple comorbidities and suffer from critical coronary artery disease (CAD). Transcatheter aortic valve replacement (TAVR) has become the therapy of choice for moderate to high-risk patients. Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) offers the possibility of temporary cardiac support to manage life-threatening critical situations. CASE SUMMARY: Here, we describe the management of a patient with severe AS and CAD with impaired left ventricular ejection fraction (LVEF). We used v-a-ECMO as an emergency strategy in cardiogenic shock during a high-risk coronary intervention to stabilize the patient, and as a further bridge to TAVR. DISCUSSION: Very high-risk patients with severe AS are unlikely to tolerate the added risk of surgical aortic valve replacement. Using ECMO may help them to benefit from TAVR as the only treatment option available.
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Ahsan et al. (2021) conducted a case report in Severe aortic stenosis and severe coronary artery disease with cardiogenic shock (n=1). Venoarterial extracorporeal membrane oxygenation (v-a-ECMO) as a bridge to transcatheter aortic valve replacement (TAVR) was evaluated on Left ventricular ejection fraction (LVEF) and symptom resolution.
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