Transcatheter aortic valve replacement in left ventricular assist device patient-overcoming the complications with transapical approach and circulatory arrest.
Milica BjelicBrian C AyersFrederick S LingSunil M PrasadIgor GosevPublished in: Journal of cardiac surgery (2020)
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.
Keyphrases
- aortic valve
- transcatheter aortic valve replacement
- left ventricular assist device
- aortic stenosis
- aortic valve replacement
- transcatheter aortic valve implantation
- cardiac arrest
- case report
- artificial intelligence
- extracorporeal membrane oxygenation
- mitral valve
- early onset
- pulmonary hypertension
- cardiopulmonary resuscitation
- risk assessment
- risk factors
- minimally invasive
- pulmonary artery
- coronary artery
- obstructive sleep apnea
- cell cycle
- coronary artery disease
- machine learning
- drug induced
- acute respiratory distress syndrome
- atrial fibrillation
- ultrasound guided
- ejection fraction
- mechanical ventilation
- positive airway pressure