Heart Transplantation and Thromboembolic Risk In Patients With Percutaneous Aortic Valve Prosthesis and Left Ventricular Assist Device: A Case Report.

Autor: Adsuar-Gómez A; Cardiac Surgery Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain. Electronic address: alejandro.adsuar@gmail.com., González-Calle A; Cardiac Surgery Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain., Ramos-Barragán B; Cardiac Surgery Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain., Rezaei K; Cardiac Surgery Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain., Rodríguez-Mora F; Cardiac Surgery Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain., Sobrino-Márquez JM; Cardiology Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain., Grande-Trillo A; Cardiology Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain., Borrego-Domínguez JM; Cardiac Surgery Department, Heart Area, Virgen del Rocío University Hospital, Seville, Spain.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2023 Dec; Vol. 55 (10), pp. 2309-2311. Date of Electronic Publication: 2023 Nov 03.
DOI: 10.1016/j.transproceed.2023.09.008
Abstrakt: Transcatheter aortic valve replacements have become a good option for patients with aortic valve disease and high surgical risk. Thromboembolism is reported as a relatively common complication of Transcatheter aortic valve replacement. This risk may be increased in patients who have left ventricular assist devices, as valve motion is drastically reduced. We present the case of a 65-year-old man with a history of alcoholism and valvular cardiomyopathy (severe chronic aortic insufficiency) with severe left ventricular dysfunction. Improvement in ventricular function followed the cessation of alcohol consumption, but still in poor clinical condition. Due to his high surgical risk, it was decided to implant a percutaneous aortic valve to treat the valve deficiency. Two months later, he suffered from a first episode of embolic stroke, which he successfully recovered. Despite the treatment, his clinical status did not improve (INTERMACS 3-4), and he was referred for heart transplantation. A left ventricular assist device was implanted as a bridge to the transplant. While on the waiting list, he suffered from other 3 episodes of stroke, 2 of them requiring mechanical thrombectomy. Finally, his transplant was performed with a favorable postoperative clinical course. Heart transplantation may be feasible in patients with multiple intracardiac devices in left chambers, although we must be aware of the increased thromboembolic risk, especially when used in combination.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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