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

Abstract

Background: Cardiogenic shock due to severe aortic regurgitation in patients with left ventricle assist devices is a life threatening condition. Here, we consider transcatheter aortic valve implantation as a treatment option.

Methods and results: A patient with a left ventricle assist device was presented to us with cardiogenic shock due to severe aortic regurgitation. We successfully implanted a transcatheter aortic valve in emergency setting. The patient recovered and underwent cardiac transplantation three months afterwards. We performed a systematic literature review and identified 10 cases of patients with a left ventricle assist device undergoing transcatheter aortic valve implantation. In these cases, there was no procedural related mortality reported. In four (40%) patients, transcatheter aortic valve implantation resulted in significant paravalvular aortic regurgitation. In two of these cases it was due to migration of the valve towards the left ventricle.

Conclusions: 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.

Keywords: Aortic regurgitation; left ventricle assist device; transcatheter aortic valve implantations.