ArticleJournal of cardiovascular development and disease2026
Balloon-Expandable Transcatheter Aortic Valve Implantation for LVAD-Associated Native Aortic Insufficiency: A Single-Center Experience.
Article in Journal of cardiovascular development and disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAortic insufficiency (AI) during long-term left ventricular assist device (LVAD) support creates a maladaptive recirculatory loop that impairs forward flow, increases left ventricular filling pressures, leading to progressive congestion, and accelerates right ventricular dysfunction. Surgical correction carries high risk, making transcatheter aortic valve implantation (TAVI) an alternative strategy, although outcomes are challenged by complex annular geometry and the absence of calcific anchoring.
methodsWe performed a retrospective single-center analysis of consecutive LVAD-supported patients undergoing TAVI for native AI. Annular sizing was area-based with a predefined oversizing strategy of approximately 15-30%, adjusted to annular geometry. Balloon-expandable valves were implanted using controlled deployment under rapid pacing and temporary LVAD flow reduction. Outcomes were assessed according to VARC-3 definitions.
resultsFourteen patients underwent TAVI. The cohort demonstrated high anatomical complexity, including annular eccentricity (median 0.21 [IQR 0.19-0.23]), horizontal aorta (42.9%), and flared left ventricular outflow tract (LVOT) morphology (50%). Median annular area was 528 mm
conclusionsIn anatomically complex LVAD patients, an anatomy-driven balloon-expandable TAVI strategy achieved elimination of clinically significant AI with zero procedural mortality. In our interpretation, mortality reflected the advanced stage of heart failure at the time of intervention rather than acute device-related failure.
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