Key result
TrilogyXT TAVR safely eliminates severe aortic regurgitation in LVAD support.
Why the study?
Up to 30% of patients with LVAD develop moderate to severe aortic regurgitation within the first year, and high perioperative risk often prohibits surgical aortic valve replacement in these patients.
Case Report (n=1)
TAVR using a dedicated valve system is a feasible and effective treatment for severe aortic regurgitation in patients with an LVAD who are at high surgical risk.
Successful TAVR with dedicated valve feasible in high-risk LVAD patient with severe AR; leaves open need for prospective data on durability and selection.
Background: Up to 30% of patients with the left ventricular assist device (LVAD) develop moderate to severe aortic regurgitation (AR) within the first year. Surgical aortic valve replacement (SAVR) is the treatment of choice in patients with native AR. However, the high perioperative risk in patients with LVAD might prohibit surgery and choice of therapy is challenging. Case summary: We report on a 55-year-old female patient with a severe AR 15 months after implantation of LVAD due to advanced heart failure (HF) as a consequence of ischaemic cardiomyopathy. Surgical aortic valve replacement was discarded due to high surgical risk. Thus, the decision was made to evaluate a transcatheter aortic valve replacement (TAVR) with the TrilogyXTä prothesis (JenaValve Technology, Inc., CA, USA). Echocardiographic and fluoroscopic control showed an optimal valve position with no evidence of valvular or paravalvular regurgitation. The patient was discharged 6 days later in a good general condition. At the 3-month follow-up, the patient showed noteworthy symptomatic improvement with no sign of HF. Discussion: Aortic regurgitation is a common complication among advanced HF patients treated with LVADSystems and associated with a deterioration in the quality of life and worsen clinical prognosis. The treatment options are limited to percutaneous occluder devices, SAVR, off-label TAVR, and heart transplantation. With the approval of the TrilogyXT JenaValve system, a novel dedicated TF-TAVR option is now available. Our experience demonstrates the technical feasibility and safety of this system in patients with LVAD and AR resulting in effective elimination of AR.
No takes yet. Share an insight, caveat, or question.
Goncharov et al. (2023) conducted a case report in Severe aortic regurgitation in a patient with a left ventricular assist device (n=1). Transfemoral transcatheter aortic valve replacement (TAVR) with the TrilogyXT prosthesis was evaluated on Technical feasibility, safety, and elimination of aortic regurgitation. Transfemoral TAVR using the TrilogyXT prosthesis was technically feasible and safe in a 55-year-old female with an LVAD and severe aortic regurgitation, resulting in effective elimination of AR.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: