Key result
LA-FA pVAD successfully bridges severe aortic stenosis and cardiogenic shock to TAVR.
Why the study?
Patients with cardiogenic shock secondary to severe aortic stenosis have exceedingly high surgical risk, and using an LA-FA pVAD as tMCS before TAVR may offer a viable, lifesaving alternative.
Does LA-FA pVAD improve procedural feasibility and outcomes in patients with severe aortic stenosis-related cardiogenic shock undergoing TAVR?
Case Report (n=1)
No
Does LA-FA pVAD improve procedural feasibility and outcomes in patients with severe aortic stenosis-related cardiogenic shock undergoing TAVR?
LA-FA pVAD is a feasible, potentially life-saving temporary mechanical support strategy to bridge patients with severe aortic stenosis and cardiogenic shock to definitive TAVR.
BACKGROUND: Patients with cardiogenic shock secondary to severe aortic stenosis represent a population at exceedingly high surgical risk. In this setting, the use of a left atrial-to-femoral arterial bypass percutaneous ventricular assist device (LA-FA pVAD) as temporary mechanical circulatory support (tMCS), followed by transcatheter aortic valve replacement (TAVR), may offer a viable, potentially lifesaving alternative. CASE SUMMARY: A 73-year-old man with known aortic stenosis was admitted with cardiogenic shock. Given the hemodynamic compromise associated with low-flow, low-gradient severe aortic stenosis, tMCS was initiated to stabilize end-organ perfusion. Subsequent TAVR was successfully performed, resulting in rapid clinical recovery. DISCUSSION: This case highlights the feasibility of performing TAVR in severe aortic stenosis-related cardiogenic shock under tMCS. LA-FA pVAD provides effective unloading and systemic perfusion, bridging unstable patients to definitive valve intervention. TAKE-HOME MESSAGE: An LA-FA pVAD can safely support TAVR in severe aortic stenosis-related cardiogenic shock.
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Witzke et al. (2025) conducted a case report in Cardiogenic shock secondary to severe aortic stenosis (n=1). Left atrial-to-femoral arterial bypass percutaneous ventricular assist device (LA-FA pVAD) followed by TAVR was evaluated on Hemodynamic stabilization, definitive valve intervention, and clinical recovery. An LA-FA pVAD successfully provided temporary mechanical circulatory support to bridge an unstable patient with severe aortic stenosis-related cardiogenic shock to definitive TAVR intervention.
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