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B. Zane Atkins, MD, Zubair A. Hashmi, MD, Asvin M. Ganapathi, MD, J

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Presentation on theme: "B. Zane Atkins, MD, Zubair A. Hashmi, MD, Asvin M. Ganapathi, MD, J"— Presentation transcript:

1 Surgical correction of aortic valve insufficiency after left ventricular assist device implantation 
B. Zane Atkins, MD, Zubair A. Hashmi, MD, Asvin M. Ganapathi, MD, J. Kevin Harrison, MD, G. Chad Hughes, MD, Joseph G. Rogers, MD, Carmelo A. Milano, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 146, Issue 5, Pages (November 2013) DOI: /j.jtcvs Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 A, An 18-mm AMPLATZER PI Muscular ventricular septal defect Occluder was initially used to treat aortic regurgitation presenting 6 months after left ventricular assist device implantation. The ventricular septal defect occluder can be seen inferior to the pigtail catheter (dashed arrow). B, Despite the initial success, the ventricular septal defect occluder had migrated several days later (seen on echocardiography) and was associated with recurrent severe aortic insufficiency, which prompted open aortic valve replacement. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 A, A transcatheter approach by way of the femoral artery was used to insert a bovine jugular vein valve (Melody transcatheter pulmonary valve) within the existing, regurgitant aortic bioprosthesis as valve-in-valve therapy for severe aortic insufficiency. The undeployed Melody valve can be seen within the aortic bioprosthesis. B, Postdeployment image of the Melody valve within the bioprosthesis, with mild, residual aortic insufficiency present. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Transesophageal echocardiogram demonstrating trivial aortic insufficiency at HeartMate II left ventricular assist device implantation with grading based on the width of the regurgitant jet vena contracta.14 At present, it is unclear whether nonsignificant aortic insufficiency predisposes the patient to worsening valvular regurgitation after left ventricular assist device implantation. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

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