{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T18:37:59Z","timestamp":1781375879618,"version":"3.54.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":2610,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T00:00:00Z","timestamp":1543276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Severe aortic regurgitation (AR) is a rare but significant complication of ventricular assist device therapy. Experience with transcatheter aortic valve replacement (TAVR) in this setting of patients is very limited, while the scarcely reported cases exclusively refer to TAVR under continuous-flow left ventricular assist devices. Here, we present the first successful TAVR while running a pulsatile-flow biventricular assist device (PF-BiVAD). Clinical data were collected based on the patient's electronic medical records after the patient's consent was obtained. We describe the case of a 57-year-old man in whom a PF-BiVAD (EXCOR, Berlin Heart, Berlin, Germany) had been initially inserted after fulminant myocarditis with subsequent severe dilated cardiomyopathy as bridge-to-transplantation therapy. Over the following 2 years, the patient developed severe de novo AR under PF-BiVAD therapy. This, along with progressive cardiac decompensation, led to the decision for TAVR by our heart team as a minimal invasive approach for severe AR. TAVR using two Edwards SAPIEN 3 bioprostheses as a valve-in-valve procedure resulted in a significant reduction of AR from severe to mild, with trace paravalvular leakage and without significant pressure gradients. The patient underwent total orthotopic heart transplantation afterwards. This is the first report of successful TAVR in a patient with severe de novo AR while running a PF-BiVAD.<\/jats:p>","DOI":"10.1002\/ehf2.12384","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T04:34:31Z","timestamp":1543293271000},"page":"217-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Transfemoral Aortic Valve Replacement for Severe Aortic Valve Regurgitation in a Patient with a Pulsatile-Flow Biventricular Assist Device"],"prefix":"10.1093","volume":"6","author":[{"given":"Bruna","family":"Gomes","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffi","family":"Bekeredjian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Leuschner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Ehlermann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]},{"name":"Department of Internal Medicine, Kurpfalzkrankenhaus , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"Schmack","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kurpfalzkrankenhaus , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjang","family":"Ruhparwar","sequence":"additional","affiliation":[{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]},{"name":"Department of Cardiac Surgery, University of Heidelberg , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip W.","family":"Raake","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo A.","family":"Katus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Kreusser","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University of Heidelberg , Heidelberg ,","place":["Germany"]},{"name":"DZHK (German Center for Cardiovascular Research), partner site Heidelberg\/Mannheim , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,11,27]]},"reference":[{"key":"2026012115101982300_ehf212384-bib-0001","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.jacc.2017.03.011","article-title":"2017 AHA\/ACC focused update of the 2014 AHA\/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"70","author":"Nishimura","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2026012115101982300_ehf212384-bib-0002","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart 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EXCOR((R)) adult pumps with bileaflet valves: a prospective study","volume":"107","author":"Schmack","year":"2018","journal-title":"Clin Res Cardiol:"},{"key":"2026012115101982300_ehf212384-bib-0009","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1161\/CIRCHEARTFAILURE.113.000473","article-title":"Valvular heart disease in patients supported with left ventricular assist devices","volume":"7","author":"Wang","year":"2014","journal-title":"Circ Heart Fail"},{"key":"2026012115101982300_ehf212384-bib-0010","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/MAT.0000000000000447","article-title":"Percutaneous transcatheter interventions for aortic insufficiency in continuous-flow left ventricular assist device patients: a systematic review and meta-analysis","volume":"63","author":"Phan","year":"2017","journal-title":"ASAIO J"},{"key":"2026012115101982300_ehf212384-bib-0011","first-page":"151","article-title":"Percutaneous transcatheter therapies for the management of 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