Trans-catheter closure of the native aortic valve with an Amplatzer Occluder to treat progressive aortic regurgitation after implantation of a left-ventricular assist device

Abstract

We report on a patient with ischaemic dilated cardiomyopathy, who developed progressive regurgitation of his native aortic valve after implantation of a left-ventricular assist device (LVAD, HeartMate II). Increasing regurgitant volume led to reduced effective cardiac output and worsening of symptoms. To overcome aortic regurgitation, we successfully closed his aortic valve minimally invasively using the Amplatzer(®) P.I. Muscular VSD Occluder. This led to instant haemodynamic stabilisation. We observed significant residual regurgitation through the Occluder during the initial phase, which led temporarily to increased haemolysis and subsequently to worsening of kidney function; once the haemolysis ceased, we noted a very good interventional and clinical result at short-term follow-up.