Percutaneous Transcatheter Closure of the Aortic Valve Hartmuth B. Bittner, MD, PhD, Bradford Ledzian, PA-C, and Rohit Bhatheja, MD Division of Thoracic Transplantation, Section of Cardiovascular and Thoracic Surgery, Florida Hospital Orlando; and Florida Heart Group, Orlando, Florida

Fig 2.

Fig 1.

A

74-year-old man presented with severe right and left heart failure, multiorgan dysfunction, and hepatorenal failure 11 months after implantation of a continuous-flow left ventricular assist device (Heartmate II, Thoratec Corp, Pleasanton, CA) as third-time redo sternotomy for ischemic cardiomyopathy. Echocardiography revealed aortic insufficiency, which is a significant complication of long-term continuous-flow left ventricu-

lar assist device support. The patient underwent percutaneous transcatheter closure of the aortic valve with a multifenestrated 30-mm Amplatzer Cribriform closure device (AGA Medical Corp, Plymouth, MN). Left heart catheterization shows the final position of the closing device at the aortic annulus (Fig 1, white arrow) and Heartmate II inflow (Fig 1, black arrow) and outflow (Fig 1, gray arrow) cannulas. Successful aortic valve closure is revealed by completion transesophageal echocardiography (Video and Fig 2; arrows point toward closure device and aortic root). Two weeks after the procedure, the cardiac hemodynamic and functional status of the patient had improved; there was no evidence of further aortic insufficiency.

The Video can be viewed in the online version of this article [http://dx.doi.org/10.1016/j.athoracsur.2015.02. 061] on http://www.annalsthoracicsurgery.org. Address correspondence to Dr Bittner, Division of Thoracic Transplantation, Section of Cardiovascular and Thoracic Surgery, Florida Hospital Orlando, 2415 N Orange Ave, Orlando, FL 32804; e-mail: hartmuth.bittner.md@ flhosp.org.

Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier

Dr Bhatheja discloses a financial relationship with St. Jude Medical.

Ann Thorac Surg 2015;99:e129  0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2015.02.061

Percutaneous transcatheter closure of the aortic valve.

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