Management of severe aortic regurgitation in a patient with cardiogenic shock using a percutaneous left ventricular assist device and transcatheter occlusion of the failed aortic valve homograft as a bridge to surgical valve replacement

Peter Pollak, D. Scott Lim, John Kern

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Acute hemodynamic compromise due to severe aortic regurgitation remains a difficult problem. The optimal management strategy and timing of surgery continues to evolve as new technologies become available. Here, we report the case of a young woman presenting with severe regurgitation of an aortic homograft who developed precipitous cardiogenic shock and multi-organ dysfunction. Her mortality risk with emergent surgery was prohibitive, and no percutaneous valve-in-valve device was available. We stabilized her condition by placing an Amplatz-type Atrial Septal Defect (ASD) occluder across her aortic valve in conjunction with a percutaneous left ventricular assist device as a bridge to surgical valve replacement. She went on to a successful surgery and recovered well. © 2013 Wiley Periodicals, Inc.

Original languageEnglish (US)
JournalCatheterization and Cardiovascular Interventions
Volume83
Issue number1
DOIs
StatePublished - Jan 1 2014

Fingerprint

Heart-Assist Devices
Aortic Valve Insufficiency
Cardiogenic Shock
Aortic Valve
Surgical Instruments
Allografts
Septal Occluder Device
Atrial Heart Septal Defects
Hemodynamics
Technology
Equipment and Supplies
Mortality

Keywords

  • cardiopulmonary support
  • valvular heart disease
  • ventricular support devices

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

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AB - Acute hemodynamic compromise due to severe aortic regurgitation remains a difficult problem. The optimal management strategy and timing of surgery continues to evolve as new technologies become available. Here, we report the case of a young woman presenting with severe regurgitation of an aortic homograft who developed precipitous cardiogenic shock and multi-organ dysfunction. Her mortality risk with emergent surgery was prohibitive, and no percutaneous valve-in-valve device was available. We stabilized her condition by placing an Amplatz-type Atrial Septal Defect (ASD) occluder across her aortic valve in conjunction with a percutaneous left ventricular assist device as a bridge to surgical valve replacement. She went on to a successful surgery and recovered well. © 2013 Wiley Periodicals, Inc.

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