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Transcatheter aortic valve replacement in left ventricular assist device patient‐overcoming the complications with transapical approach and circulatory arrest
Author(s) -
Bjelic Milica,
Ayers Brian,
Ling Frederick S.,
Prasad Sunil M.,
Gosev Igor
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15199
Subject(s) - medicine , ventricle , thoracotomy , aortic valve , cardiology , valve replacement , ventricular assist device , surgery , percutaneous , circulatory system , aortic valve replacement , cannula , stenosis , heart failure
We present the patient with severe aortic insufficiency (AI) 5 years post left ventricular assist device (LVAD) implantation. His management was complicated with unsuccessful percutaneous aortic valve closure attempt, transcatheter aortic valve replacement (TAVR) implantation with a severe paravalvular leak, eventual valve dislodgment into the left ventricle (LV), and LVAD inflow cannula occlusion. We utilized a mini‐thoracotomy approach to successfully retrieve the dislodged valve through the LV apex while deploying a valve‐in‐valve TAVR under direct visualization and deep hypothermic cardiac arrest. This case can serve as an example of the serious pitfalls and potential resolution strategies when treating LVAD‐associated AI.