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Updated: Jul 15, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
Emergency Transcatheter Aortic Valve Replacement in Cardiogenic Shock Caused by Severe Bicuspid Aortic Valve Stenosis
Martin Jurisic1, Fabian Starnecker1, Michael Joner1
1Department of Cardiovascular Diseases, German Heart Center Munich, Technical University Munich University Hospital, Munich, Germany.
Background:
Treatment of severe aortic stenosis in cardiogenic shock remains challenging, particularly in younger patients with bicuspid valve stenosis (BVS).
Case Summary:
A 51-year-old woman with severe high-gradient BVS presented in cardiogenic shock with multiorgan dysfunction. Given hemodynamic instability, the heart team proceeded with urgent transcatheter aortic valve replacement. A 26-mm balloon-expandable Edwards SAPIEN 3 Ultra RESILIA valve was successfully implanted, resulting in rapid hemodynamic stabilization.
Discussion:
This case highlights the importance of urgent heart team decision-making in unstable patients with severe BVS. Lifetime management requires individualized device selection considering annular dimensions, calcification pattern, coronary access, and future redo-procedure strategies.
Take-Home Messages:
In the presence of refractory cardiogenic shock, transcatheter aortic valve replacement may be the preferred treatment strategy and should be considered as part of an individualized lifetime management strategy.
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