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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2019; 08(01): e33-e36
DOI: 10.1055/s-0039-1698412
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

TAVI Using a Self-Expandable Device for Aortic Regurgitation Following LVAD Implantation

Harun Sarwari
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
Andreas Schaefer
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
Markus J. Barten
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
,
Lenard Conradi
1   Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany
› Author Affiliations
Further Information

Publication History

28 June 2019

12 August 2019

Publication Date:
04 November 2019 (online)

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Abstract

Background In patients treated by left ventricular assist device (LVAD), aortic regurgitation (AR) may occur. Secondary surgery to correct AR is considered high risk.

Case Description We report a case of severe AR following LVAD implantation in a patient who was subsequently treated by transcatheter aortic valve implantation (TAVI) using the latest generation self-expandable transcatheter heart valve (THV) (Boston Scientific Acurate neo, size M [Boston Scientific, Marlborough, Massachusetts, United States]). TAVI followed modified procedural protocol and sizing algorithm. THV implantation without prior balloon aortic valvuloplasty resulted in an adequate valve function without leakage.

Conclusion This THV may be particularly well suited for TAVI subsequent to LVAD implantation if modified sizing and deployment considerations are appreciated.

Keywords

left ventricular assist device - aortic regurgitation - transcatheter aortic valve implantation - heart failure
 

  • References

  • 1 Cowger J, Pagani FD, Haft JW, Romano MA, Aaronson KD, Kolias TJ. The development of aortic insufficiency in left ventricular assist device-supported patients. Circ Heart Fail 2010; 3 (06) 668-674
    CrossrefPubMedGoogle Scholar
  • 2 Pak SW, Uriel N, Takayama H. , et al. Prevalence of de novo aortic insufficiency during long-term support with left ventricular assist devices. J Heart Lung Transplant 2010; 29 (10) 1172-1176
    CrossrefPubMedGoogle Scholar
  • 3 Toda K, Fujita T, Domae K, Shimahara Y, Kobayashi J, Nakatani T. Late aortic insufficiency related to poor prognosis during left ventricular assist device support. Ann Thorac Surg 2011; 92 (03) 929-934
    CrossrefPubMedGoogle Scholar
  • 4 van der Werf HW, Schurer RA, Vonck TE. , et al. Emergency transcatheter aortic valve implantation in patients with severe aortic regurgitation and a left ventricle assist device: a case report and systematic review. Eur Heart J Acute Cardiovasc Care 2017; 6 (08) 719-727
    CrossrefPubMedGoogle Scholar
  • 5 Spina R, Anthony C, Muller DW, Roy D. Transcatheter aortic valve replacement for native aortic valve regurgitation. Interv Cardiol (Lond) 2015; 10 (01) 49-54
    CrossrefPubMedGoogle Scholar
  • 6 Jiang J, Liu X, He Y. , et al. Transcatheter aortic valve replacement for pure native aortic valve regurgitation: a systematic review. Cardiology 2018; 141 (03) 132-140
    CrossrefPubMedGoogle Scholar
  • 7 Toggweiler S, Cerillo AG, Kim WK. , et al. Transfemoral implantation of the Acurate neo for the treatment of aortic regurgitation. J Invasive Cardiol 2018; 30 (09) 329-333
    PubMedGoogle Scholar