Aortic stenosis complicated by cardiogenic shock treated by transcatheter aortic valve replacement with extracorporeal membrane oxygenation: A case report.

RATIONALE

Cardiogenic shock secondary to aortic stenosis (AS) is a challenging problem owing to the high mortality associated with treatment, and successful treatment of such patients has been rare.

PATIENT CONCERNS

A 77-year-old man presented with exercise intolerance and progressive exertional dyspnea and chest pain. The patient was suffered from cardiogenic shock after percutaneous coronary intervention.

DIAGNOSIS

He was diagnosed by transthoracic echocardiography (TTE) and coronary angiogram. His main diagnose was AS and coronary artery disease.

INTERVENTION

The patient received venoarterial extracorporeal membrane oxygenation (VA-ECMO) and transcatheter aortic valve replacement (TAVR).

OUTCOME

As of the 5-month follow-up, the patient was well, and capable of basic independent living. The TTE suggested that the left ventricular end-diastolic volume had decreased from 66 to 45 mm and the left ventricular ejection fraction had risen from 20% to 50%.

LESSONS

Patients with cardiogenic shock secondary to AS are very difficult to treat medically. ECMO with TAVR may be a reasonable strategy.