Transfemoral aortic valve replacement for severe aortic valve regurgitation in a patient with a pulsatile-flow biventricular assist device

• Verfasst von: Gomes Botelho Quintas, Bruna [VerfasserIn]
• Verfasst von: Bekeredjian, Raffi [VerfasserIn]
• Verfasst von: Leuschner, Florian [VerfasserIn]
• Verfasst von: Ehlermann, Philipp [VerfasserIn]
• Verfasst von: Schmack, Bastian [VerfasserIn]
• Verfasst von: Ruhparwar, Arjang [VerfasserIn]
• Verfasst von: Raake, Philip [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Kreußer, Michael [VerfasserIn]
• Titel: Transfemoral aortic valve replacement for severe aortic valve regurgitation in a patient with a pulsatile-flow biventricular assist device
• Verf.angabe: Bruna Gomes, Raffi Bekeredjian, Florian Leuschner, Philipp Ehlermann, Bastian Schmack, Arjang Ruhparwar, Philip W. Raake, Hugo A. Katus and Michael M. Kreusser
• Jahr: 2019
• Jahr des Originals: 2018
• Umfang: 5 S.
• Fussnoten: Published online 27 November 2018 ; Gesehen am 07.02.2019
• Titel Quelle: Enthalten in: European Society of CardiologyESC heart failure
• Ort Quelle: Chichester : Wiley, 2014
• Jahr Quelle: 2019
• Band/Heft Quelle: 6(2019), 1, Seite 217-221
• ISSN Quelle: 2055-5822
• DOI: doi:10.1002/ehf2.12384
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Biventricular assist device
• Sach-SW: Bridge to transplantation
• Sach-SW: Terminal heart failure
• Sach-SW: Transcatheter aortic valve replacement
• K10plus-PPN: 158738373X
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Severe aortic regurgitation (AR) is a rare but significant complication of ventricular assist device therapy. Experience with transcatheter aortic valve replacement (TAVR) in this setting of patients is very limited, while the scarcely reported cases exclusively refer to TAVR under continuous-flow left ventricular assist devices. Here, we present the first successful TAVR while running a pulsatile-flow biventricular assist device (PF-BiVAD). Clinical data were collected based on the patient's electronic medical records after the patient's consent was obtained. We describe the case of a 57-year-old man in whom a PF-BiVAD (EXCOR, Berlin Heart, Berlin, Germany) had been initially inserted after fulminant myocarditis with subsequent severe dilated cardiomyopathy as bridge-to-transplantation therapy. Over the following 2 years, the patient developed severe de novo AR under PF-BiVAD therapy. This, along with progressive cardiac decompensation, led to the decision for TAVR by our heart team as a minimal invasive approach for severe AR. TAVR using two Edwards SAPIEN 3 bioprostheses as a valve-in-valve procedure resulted in a significant reduction of AR from severe to mild, with trace paravalvular leakage and without significant pressure gradients. The patient underwent total orthotopic heart transplantation afterwards. This is the first report of successful TAVR in a patient with severe de novo AR while running a PF-BiVAD.