Balloon Aortic Valvuloplasty under Temporary Mechanical Circulatory Support as a Bridge to Aortic Valve Replacement in a Patient with Hemodynamic Failure Secondary to Critical Aortic Valve Stenosis

Authors

  • Salil Deo
  • Kevin L. Greason
  • Rajiv Gulati
  • Allan S. Jaffe
  • David R. Holmes

DOI:

https://doi.org/10.1532/HSF98.20111055

Abstract

Aortic valve replacement in the setting of critical aortic valve stenosis with cardiogenic shock is associated with high mortality, yet surgery is the only definitive treatment. We present the case of a patient with critical aortic valve stenosis and cardiogenic shock who received a short period of percutaneous mechanical support and balloon aortic valvuloplasty that resulted in rapid clinical improvement. The patient then underwent uneventful aortic valve replacement. We believe that temporary mechanical circulatory support coupled with balloon aortic valvuloplasty helped to restore hemodynamic stability before surgery, leading to a better outcome.

References

Christ G, Zehetgruber M, Mundigler G, et al. 1997. Emergency aortic valve replacement for critical aortic stenosis. A lifesaving treatment for patients with cardiogenic shock and multiple organ failure. Intensive Care Med 23:297-300.nDoguet F, Godin M, Lebreton G, et al. 2010. Aortic valve replacement after percutaneous valvuloplasty—an approach in otherwise inoperable patients. Eur J Cardiothorac Surg 38:394-9.nFrank C, Palanichamy N, Kar B, et al. 2006. Use of a percutaneous ventricular assist device for treatment of cardiogenic shock due to critical aortic stenosis. Tex Heart Inst J 33:487-9.nKar B, Gregoric I, Basra SS, Idelchik GM, Loyalka P. 2010. The percutaneous ventricular assist device in severe refractory cardiogenic shock. J Am Coll Cardiol 57:688-96.nLemos P, Cummins P, Lee C, et al. 2003. Usefulness of percutaneous left ventricular assistance to support high-risk percutaneous coronary interventions. Am J Cardiol 91:479-81.nO'Brien SM, Shahian DM, Filardo G, et al. 2009. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 2-isolated valve surgery. Ann Thorac Surg 88(suppl):S23-42.nPasic M, Unbehaun A, Dreysse S, et al. 2010. Transapical aortic valve implantation after previous aortic valve replacement: clinical proof of the "valve-in-valve" concept. J Thorac Cardiovasc Surg 142:270-7.nWenaweser P, Buellesfeld L, Gerckens U, Grube E. 2007. Percutaneous aortic valve replacement for severe aortic regurgitation in degenerated bioprosthesis: the first valve in valve procedure using the Corevalve Revalving system. Catheter Cardiovasc Interv 70:760-4.n

Published

2012-06-14

How to Cite

Deo, S., Greason, K. L., Gulati, R., Jaffe, A. S., & Holmes, D. R. (2012). Balloon Aortic Valvuloplasty under Temporary Mechanical Circulatory Support as a Bridge to Aortic Valve Replacement in a Patient with Hemodynamic Failure Secondary to Critical Aortic Valve Stenosis. The Heart Surgery Forum, 15(3), E177-E179. https://doi.org/10.1532/HSF98.20111055

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