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A Left Atrial–to–Femoral Arterial Bypass Percutaneous Ventricular Assist Device as a Bridge to Transcatheter Aortic Valve Replacement

Year: 2025

Type: article

Abstract: BACKGROUND: Patients with cardiogenic shock secondary to severe aortic stenosis represent a population at exceedingly high surgical risk. In this setting, the use of a left atrial-to-femoral arterial bypass percutaneous ventricular assist device (LA-FA pVAD) as temporary mechanical circulatory support (tMCS), followed by transcatheter aortic valve replacement (TAVR), may offer a viable, potentially lifesaving alternative. CASE SUMMARY: A 73-year-old man with known aortic stenosis was admitted with cardiogenic shock. Given the hemodynamic compromise associated with low-flow, low-gradient severe aortic stenosis, tMCS was initiated to stabilize end-organ perfusion. Subsequent TAVR was successfully performed, resulting in rapid clinical recovery. DISCUSSION: This case highlights the feasibility of performing TAVR in severe aortic stenosis-related cardiogenic shock under tMCS. LA-FA pVAD provides effective unloading and systemic perfusion, bridging unstable patients to definitive valve intervention. TAKE-HOME MESSAGE: An LA-FA pVAD can safely support TAVR in severe aortic stenosis-related cardiogenic shock.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106331

Authors: Enhua Wang, Christian Witzke, Emmanuel Akuna, Behnam Bozorgnia, Alexandra Tuluca

Institution: Jefferson Einstein Philadelphia Hospital

Language: English

Topic: Mechanical Circulatory Support Devices

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850