Rescue TAVI for Aortic Regurgitation after Left Ventricular Assist Device Implantation Following Preoperative Impella® Support.
Rescue TAVI for Aortic Regurgitation after Left Ventricular Assist Device Implantation Following Preoperative Impella® Support.
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术前 Impella® 支持后植入左心室辅助装置后挽救 TAVI 治疗主动脉瓣反流。
DOI：
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
M. Pichlmaier
中科院分区：
文献类型：
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作者：
Florian E M Herrmann;P. Wellmann;V. von Dossow;S. Massberg;C. Hagl;R. Schramm;M. Pichlmaier
一名患有失代偿性心肌病的患者需要使用 Impella® 心脏泵进行侵入性血流动力学支持。在进一步的治疗过程中，体外生命支持（ECLS）变得必要，患者被桥接至左心室辅助装置（LVAD）植入。术后，由于新的主动脉瓣反流（AR），患者的情况没有达到预期的改善，这很可能是由之前放置的 Impella 引起的。植入 SAPIEN 3 经导管主动脉瓣作为应急策略；由于瓣周反流，需要进行额外的瓣中瓣抢救。这导致瓣膜功能的恢复和血流动力学的改善。 TAVI 似乎是 LVAD 植入术后 AR 的一个有价值的缓解选择。
A patient presented with a decompensated cardiomyopathy requiring invasive hemodynamic support with an Impella® heart pump. Extracorporeal life support (ECLS) became necessary during the further course and the patient was bridged to left ventricular assist device (LVAD) implantation. Postoperatively, the patient did not improve as expected due to new aortic regurgitation (AR) that was most likely caused by the previously placed Impella. A SAPIEN 3 transcatheter aortic valve was implanted as a bail-out strategy; an additional valve-in-valve rescue was required due to paravalvular regurgitation. This resulted in a restitution of valvular function and hemodynamic improvement. TAVI appears to be a valuable bail-out option for postoperative AR following LVAD implantation.