doiSerbia

Left ventricular assist device implantation and concomitant aortic valve replacement

Mikić Aleksandar (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia)
Nestorović Emilija (Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia)
Bilbija Ilija (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia)
Terzić Duško (Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia)
Putnik Svetozar (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Cardiac Surgery, Belgrade, Serbia)

Introduction. The implantable device for mechanical support of the left ventricular circulation (LVAD) is widely applied as a therapeutic option for survival and improvement of the quality of life in patients with the end-stage heart failure. The objective of our paper was to present the implantation of the aforementioned device together with the aortic valve replacement in the same procedure. Case outline. The patient was admitted to the hospital during his terminal stage of heart failure, with ejection fraction of 18%. The ergospirometry test showed that the maximum VO2 was 10.1 ml/kg/min. Because the medicament therapy hadn’t provided adequate results, the LVAD device was implanted as a bridge until transplantation. Due to severe aortic insufficiency, the aortic valve was concomitantly replaced with bioprosthesis in order to prevent the negative effect of this valvular disease on pump work and clinical outcome. Conclusion. This case report confirms that LVAD implantation with the correction of a significant aortic insufficiency is a procedure with satisfactory short-term and long-term results.

Keywords: cardiac failure, LVAD, aortic valve