Emergency transcatheter aortic valve implantation in patients with severe aortic regurgitation and a left ventricle assist device: A case report and systematic review

Abstract

Our case report and review of literature suggests that transcatheter aortic valve implantation is a feasible and lifesaving treatment option for left ventricle assist device patients presenting with severe aortic regurgitation.

Continuous-flow left ventricular assist device: Current knowledge, complications, and future directions

“…4C) [48,49]. The procedure must be planned carefully because calcified aortic annulus is normally absent, and the prosthesis can embolize [50][51][52].…”

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

“…To date, anecdotal reports of treatment with THV in patients with pure AR following LVAD implantation exist. 4 In most of these cases, CoreValve THVs were used (Medtronic, Inc, Minneapolis, Minnesota, United States) and TAVI was demonstrated to be a reasonable option. However, from larger series on use of this particular self-expandable THV in pure, noncalcified AR it is known that the implant procedure is not trivial with relevant rates of sequential valve implantation for malpositioning of the first THV as well as an incidence of residual AR≥ grade II in 21% of the patients.…”

Transfemoral transcatheter aortic valve replacement with a self-expanding valve for severe aortic regurgitation in a patient with left ventricular assist device

“…Appropriate oversizing is of utmost importance to maximize anchoring of the valve at the annulus, to reduce the possibility of ventricular migration, and to optimize hemodynamics in the setting of a LVAD. Of the previous seven cases of TAVR in patients with LVAD and aortic valve insufficiency in non‐calcified or minimally calcified aortic valve described in the literature, only one was performed with a balloon‐expandable valve as the sole valve . Of the six cases performed with a Medtronic Corevalve, one required further post‐dilation for residual aortic regurgitation and two experienced ventricular migration of the transcatheter valve, one of which was treated with the implantation of a second Corevalve .…”