Why the study?
Does transcatheter aortic valve implantation provide a feasible and safe treatment option in patients with a left ventricle assist device presenting with severe aortic regurgitation?
Does transcatheter aortic valve implantation provide a feasible and safe treatment option in patients with a left ventricle assist device presenting with severe aortic regurgitation?
Transcatheter aortic valve implantation is a feasible and potentially lifesaving emergency treatment for patients with left ventricle assist devices who develop severe aortic regurgitation, though there is a notable risk of paravalvular leak and valve migration.
May serve as emergency rescue for severe AR in LVAD patients despite paravalvular regurgitation risk; leaves open need for dedicated valves and larger studies.
BACKGROUND: Cardiogenic shock due to severe aortic regurgitation in patients with left ventricle assist devices is a life threatening condition. Here, we consider transcatheter aortic valve implantation as a treatment option. METHODS AND RESULTS: A patient with a left ventricle assist device was presented to us with cardiogenic shock due to severe aortic regurgitation. We successfully implanted a transcatheter aortic valve in emergency setting. The patient recovered and underwent cardiac transplantation three months afterwards. We performed a systematic literature review and identified 10 cases of patients with a left ventricle assist device undergoing transcatheter aortic valve implantation. In these cases, there was no procedural related mortality reported. In four (40%) patients, transcatheter aortic valve implantation resulted in significant paravalvular aortic regurgitation. In two of these cases it was due to migration of the valve towards the left ventricle. CONCLUSIONS: Our case report and review of literature suggests that transcatheter aortic valve implantation is a feasible and lifesaving treatment option for left ventricle assist device patients presenting with severe aortic regurgitation.
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Werf et al. (2016) studied this question.
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