Left atrial VA-ECMO followed by emergent percutaneous valve-in-valve TAVR successfully resuscitated a patient with severe rapid-onset bioprosthetic aortic insufficiency-induced cardiogenic shock.
Case Report (n=1)
Left atrial VA-ECMO combined with emergent valve-in-valve TAVR can be a successful rescue strategy for severe bioprosthetic aortic insufficiency-induced cardiogenic shock.
Conventional venoarterial extracorporeal membrane oxygenation (VA-ECMO) places a functional afterload burden on the left ventricle. In the setting of acute severe aortic insufficiency-induced cardiogenic shock, the utility of VA-ECMO in combination with a failing valve may result in catastrophic haemodynamic consequences. This challenge is compounded when the culprit is a failing surgical bioprosthetic valve. We present a case of severe rapid-onset bioprosthetic aortic insufficiency-induced cardiogenic shock successfully resuscitated with left atrial VA-ECMO promptly followed by emergent percutaneous valve-in-valve transaortic valve replacement. We discuss the logistics, implications, and associated haemodynamic manifestations in utilizing this strategy for such disease processes.
Golzarian et al. (Fri,) conducted a case report in Severe rapid-onset bioprosthetic aortic insufficiency-induced cardiogenic shock (n=1). Left atrial VA-ECMO and emergent valve-in-valve TAVR was evaluated on Successful resuscitation. Left atrial VA-ECMO followed by emergent percutaneous valve-in-valve TAVR successfully resuscitated a patient with severe rapid-onset bioprosthetic aortic insufficiency-induced cardiogenic shock.