Faculty Collaboration Database

Concomitant Valve-in-Valve Transcatheter Aortic Valve Replacement and Left Ventricular Assist Device Implantation. Innovations (Phila) 2017;12(2):147-149

Date

03/23/2017

Pubmed ID

28328570

DOI

10.1097/IMI.0000000000000360

Scopus ID

2-s2.0-85015898155 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation. Transthoracic echocardiography results showed severe aortic prosthetic valve deterioration with moderate aortic regurgitation as well as severe left ventricular dysfunction (ejection fraction, 11%). After redosternotomy, we performed transcatheter AVR via the ascending aorta and subsequent LVAD implantation. The postoperative course was uneventful. Generally, patients with structural deterioration of a bioprosthetic valve who report for LVAD therapy present considerable challenges to the surgeon. Concomitant transcatheter AVR offers a less-invasive alternative to surgical AVR that minimizes ischemic injury to myocardium.

Author List

Murashita T, Joyce DL, Pochettino A, Stulak JM, Joyce LD

MESH terms used to index this publication - Major topics in bold

Aged
Aortic Valve Stenosis
Heart Failure
Heart Valve Prosthesis Implantation
Heart-Assist Devices
Humans
Male
Reoperation
Transcatheter Aortic Valve Replacement
Treatment Outcome
Ventricular Function, Left