Background:
Aortic regurgitation developing after continuous flow LVAD (cf-LVAD) implantation is not uncommon and represents an eminent problem that can affect LVAD performance [1]. Currently, it is not known if the progression of aortic insufficiency (AI) differs with different LVAD models or with pump hemodynamics [1]. With increasing severity of AI, a vicious circle develops, whereby most of the pumped blood through the outflow graft regurgitates back into the left ventricle leading to ineffective LVAD function and worsening heart failure symptoms and signs [1]. Predictors of severe AI in our Patient included Age > 60 years, chronic kidney disease, LVEDD > 6.8 cm, and PCWP> 18 mmHg. Here, we present a case of a patient who received a heart transplant due to heart failure with hypoperfusion symptoms secondary to severe aortic regurgitation.