Key result
Concomitant transapical TAVI and LVAD implantation proves feasible for pure aortic regurgitation.
Why the study?
Relevant aortic regurgitation requires surgical repair at the time of LVAD implantation to reduce recirculation and ensure adequate forward flow, but surgical intervention may be precluded by extensive aortic calcification.
Case Report (n=1)
Concomitant transcatheter aortic valve implantation and LVAD implantation is a feasible hybrid procedure for patients with pure aortic regurgitation and extensive aortic calcification precluding surgical cross-clamping.
May support hybrid TAVI-LVAD in select pure AR cases; case report leaves open safety, durability, and need for prospective data.
Relevant aortic regurgitation (AR) requires surgical repair at the time of left ventricular assist device (LVAD) implantation to reduce recirculation and ensure adequate forward flow. We report here on a patient with moderate AR in a noncalcified aortic valve and extensive calcification of the ascending aorta. The latter precluded aortic-crossclamping and, thus, surgical intervention on the aortic valve. Although there were no valvular or annular calcifications, a JenaValve transcatheter heart valve was successfully placed transapically with subsequent LVAD implantation in one operation. We believe concomitant transcatheter aortic valve implantation (TAVI) and LVAD implantation is a promising hybrid procedure, even in patients with pure AR.
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Baum et al. (2012) conducted a case report in Moderate aortic regurgitation requiring LVAD implantation (n=1). Concomitant transcatheter aortic valve implantation (TAVI) and LVAD implantation was evaluated. Concomitant transcatheter aortic valve implantation and LVAD implantation was successfully performed in a patient with pure aortic regurgitation.
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