Bail-out transcatheter aortic valve implantation to reduce severe acute aortic regurgitation in a failing homograft secondary to HeartMate II ventricular assistance device.

Left ventricular assistance with surgically implanted pump devices like the HeartMate may be crucial in selected patient with end-stage heart failure. However, mainly due to its high aortic output, the pump itself may induce severe aortic regurgitation that could result in paradoxycal worsening of the anterograde perfusion after the initiation of the support. Surgical or percutaneous occlusion of the aortic valve has proved useful in these kinds of patients. Here we present a successful case of bail-out CoreValve implantation after HeartMate II positioning complicated by acute severe aortic regurgitation in a patient with a failing homograft and end-stage ventricular dysfunction, ineligible for heart transplanation.