Discussion:
Secondary aortic regurgitation is a recognizable complication occurring
after cf-LVAD implantation [2]. Severe enough, it can affect the
hemodynamic performance of the LVAD manifesting with signs of end-organ
hypoperfusion. Combined with right ventricular insufficiency, less
invasive therapeutic options like TAVI seemed adequate but were not
possible, and although high risk, the patient was listed for urgent
heart transplantation which took place a few months later. The operative
and postoperative course was unremarkable with gradual recovery of
kidney function and marked improvement of patient symptoms.