Rescue TAVI for Aortic Regurgitation after Left Ventricular Assist Device Implantation Following Preoperative Impella® Support

J Heart Valve Dis. 2017 Sep;26(5):603-605.

Abstract

A patient presented with a decompensated cardiomyopathy requiring invasive hemodynamic support with an Impella® heart pump. Extracorporeal life support (ECLS) became necessary during the further course and the patient was bridged to left ventricular assist device (LVAD) implantation. Postoperatively, the patient did not improve as expected due to new aortic regurgitation (AR) that was most likely caused by the previously placed Impella. A SAPIEN 3 transcatheter aortic valve was implanted as a bail-out strategy; an additional valve-in-valve rescue was required due to paravalvular regurgitation. This resulted in a restitution of valvular function and hemodynamic improvement. TAVI appears to be a valuable bail-out option for postoperative AR following LVAD implantation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Valve Insufficiency* / diagnosis
  • Aortic Valve Insufficiency* / etiology
  • Aortic Valve Insufficiency* / physiopathology
  • Aortic Valve Insufficiency* / surgery
  • Cardiomyopathies / complications*
  • Emergency Treatment / methods
  • Extracorporeal Circulation / methods
  • Female
  • Heart Failure* / diagnosis
  • Heart Failure* / etiology
  • Heart Failure* / physiopathology
  • Heart Failure* / surgery
  • Heart-Assist Devices*
  • Hemodynamics
  • Humans
  • Prosthesis Implantation / adverse effects*
  • Prosthesis Implantation / methods
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome