Transcatheter aortic valve migration in aortic regurgitation following left ventricular assist device

Abstract

To the Editor, Moderate-to-severe aortic regurgitation (AR) is a common complication of patients treated with continuous-flow left ventricular assist devices (CF-LVAD) that affects 35% of these patients at 5 years.1 The risk factors associated with its appearance are the absence of valvular opening, the time of progression, the presence of aortic or mitral regurgitation prior to implantation, and female sex.2 AR causes left ventricular overload and inefficient recirculation flow through the pump. Observational studies have reported that post-implantation AR is not associated with a higher mortality rate. However, it has been reported that the cardiac function deteriorates requiring some type of procedure in 33% of the patients who develop it.3 The implantation of percutaneous devices, in particular transcatheter aortic valve implantation (TAVI), has become the therapeutic alternative in this subgroup of patients in whom surgery is ill-advised because of their risk and possible future procedures.4 Although evidence is scarce on this regard, it has been described as an effective technique with disappearance of significant AR after the procedure and in the mid-term follow-up.5 This is the case of a 54-year-old woman with idiopathic dilated cardiomyopathy in situation of advanced heart failure who received the Heartmate III CF-LVAD (Abbot, Chicago, United States) as the...