Transfemoral Transcatheter Aortic Valve Implantation (TF-TAVI) for Patients With Left Ventricular Assist Device (LVAD) and Aortic Regurgitation.

Abstract

Aortic regurgitation (AR) develops in up to 25%-30% of patients with left ventricular assist device (LVAD). Treatment remains challenging since surgery confers significant peri-operative risk and the lack of valvular calcification renders transfemoral transcatheter aortic valve implantation (TF-TAVI) with non-dedicated devices technically challenging. We present a case series wherein a TF J-Valve system, a dedicated transcatheter heart valve for pure AR, emerges as an alternative treatment for AR in patients with an LVAD. We demonstrate successful deployment even in the presence of challenging anatomy including aortic root thrombus. Technical considerations when performing TF-TAVI in LVAD patients are discussed.