Percutaneous transcatheter closure of the aortic valve to treat cardiogenic shock in a left ventricular assist device patient with severe aortic insufficiency.
In this case report, we present a patient status post left ventricular assist device implantation complicated by de novo aortic insufficiency. At 8 months postimplant, the patient underwent a reoperative aortic valve repair, without complete closure of the valve. Three months after reoperation, the patient developed cardiogenic shock secondary to recurrent, severe aortic insufficiency. Ultimately, the patient underwent percutaneous, transcatheter closure of the aortic valve with an Amplatzer Cribiform device (AGA Medical Corp, Plymouth, MN). Two months post procedure, the patient remains stable with improved symptoms and functional status, and without evidence of further aortic insufficiency or device migration.
Section of Cardiac and Thoracic Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, Illinois 60637, USA. mrusso@uchicago.edu
Mark J
MJ
Russo
Benjamin H
BH
Freed
Valluvan
V
Jeevanandam
Mohammad
M
Hashmi
Jonathan D
JD
Paul
Allen
A
Anderson
Roberto M
RM
Lang
Atman P
AP
Shah
D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D006328:Cardiac Catheterization / Q000379:methods; D016638:Critical Illness; D017548:Echocardiography, Transesophageal / Q000379:methods; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D055989:Septal Occluder Device; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome