Key result
Transcatheter aortic valve replacement was an effective management strategy for severe native aortic valve insufficiency, improving hemodynamics in a patient awaiting liver transplantation.
Case Report (n=1)
TAVR can be an effective bridge to liver transplantation for patients with severe native aortic valve regurgitation and end-stage liver disease who are at high risk for traditional cardiac surgery.
May support TAVR bridging in high-risk liver candidates with severe AR; hypothesis-generating and requires prospective validation.
Coexistence of end-stage liver disease (ESLD) and severe valvular heart disease conveyed substantial risk for patients, oftentimes leading to exclusion from liver transplantation candidacy due to inability to safely offer cardiac surgery prior to transplantation. Several approaches have been described, including performing transplantation and valve surgery concurrently, or in sequence. Both options, however, have associated complications: catastrophic repercussion of peri-operative coagulopathy and organ dysfunction post-transplantation, respectively. The introduction of transcatheter procedures offered a safer alternative for high-risk patients; however, its recognized indications remained limited. A novel approach to this surgical dilemma by performing transcatheter aortic valve replacement (TAVR) for severe native aortic valve regurgitation in a patient on the liver transplant list has been presented. The procedure proved to be an effective management for the aortic valve insufficiency, improving our patient's hemodynamics in preparation for the subsequent orthotopic liver transplantation (OLT).
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Cabasa et al. (2015) conducted a case report in End-stage liver disease and severe native aortic valve regurgitation (n=1). Transcatheter aortic valve replacement (TAVR) was evaluated on Hemodynamic improvement in preparation for orthotopic liver transplantation. Transcatheter aortic valve replacement was an effective management strategy for severe native aortic valve insufficiency, improving hemodynamics in a patient awaiting liver transplantation.
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