Emerging transcatheter aortic valve implantation for aortic insufficiency after an intracorpore left ventricular assist device

Longterm left ventricular assist implantation is a therapy used in patients with end-stage heart failure and refractory to other medical, surgical, or cardiac resynchronization treatments. The most common indications are as a bridge to heart transplantation or as destination therapy. These systems maintain a continuous blood flow that has several advantages over the pulsatile one, but also has some disadvantages, such as the higher incidence of aortic insufficiency after implantation. With HeartMate 3 assistance, theoretically there would be less aortic insufficiency because it maintains a certain pulsatility. We present the case of a patient with this type of assistance as destination therapy who presented cardiogenic shock five months after implantation and who was successfully treated with the placement of a transcatheter aortic valve (TAVI), which is one of the therapeutic options for this type of complication, although there are still few cases described, especially with state-of-the-art assistance. (C) 2020 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U.