{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:11:38Z","timestamp":1789056698688,"version":"build-2803163510"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Artif Organs"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with mechanical aortic valve replacement and end-stage heart failure present major challenges when mechanical circulatory support is required, as transvalvular devices such as the Impella 5.5 are contraindicated. We report a 57-year-old man with idiopathic dilated cardiomyopathy who developed cardiogenic shock after prior mechanical aortic valve replacement. Despite cardiac resynchronization therapy defibrillator support and intra-aortic balloon pumping, he became dialysis dependent. The patient\u2019s condition progressively deteriorated, necessitating more robust mechanical circulatory support. Although durable left ventricular assist device implantation was considered, transvalvular Impella 5.5 support was precluded by the mechanical aortic valve, and simultaneous durable left ventricular assist device implantation with redo aortic valve replacement was considered high risk because of poor surgical tolerance and end-organ dysfunction. Therefore, we planned a staged surgical strategy. Reoperative aortic valve replacement with a bioprosthetic valve was therefore performed to enable Impella 5.5 implantation. Impella support resulted in hemodynamic stabilization, end-organ recovery, and improvement in risk stratification. Subsequently, a HeartMate 3 was successfully implanted as destination therapy. The patient recovered progressively and was discharged. This case demonstrates that intentional conversion to a bioprosthetic valve may be a viable strategy to enable advanced mechanical circulatory support.<\/jats:p>","DOI":"10.1007\/s10047-026-01573-8","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:06:30Z","timestamp":1785506790000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Successful destination therapy after stepwise mechanical circulatory support in a patient with cardiogenic shock following mechanical aortic valve replacement"],"prefix":"10.1007","volume":"29","author":[{"given":"Rina","family":"Ebe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuki","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiki","family":"Nagaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Kawabata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Sakurai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Nabeshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuro","family":"Takashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taishi","family":"Yonetsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Araki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Isotani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuo","family":"Sasano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3023-5014","authenticated-orcid":false,"given":"Tomoyuki","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"1573_CR1","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1093\/icvts\/ivab020","volume":"32","author":"T Toya","year":"2021","unstructured":"Toya T, Fukushima S, Shimahara Y, et al. Reverse left ventricular remodelling after aortic valve replacement for severe aortic insufficiency. Interact Cardiovasc Thorac Surg. 2021;32:846\u201354.","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"1573_CR2","doi-asserted-by":"publisher","first-page":"3318","DOI":"10.1053\/j.jvca.2022.04.010","volume":"36","author":"JM Santana","year":"2022","unstructured":"Santana JM, Dalia AA, Newton M, et al. Mechanical circulatory support options in patients with aortic valve pathology. J Cardiothorac Vasc Anesth. 2022;36:3318\u201326.","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"12","key":"1573_CR3","first-page":"948","volume":"10","author":"R Mandeep","year":"2022","unstructured":"Mandeep R, Mehra A, Nayak AA, Morris, et al. Prediction of survival after implantation of a fully magnetically levitated left ventricular assist device. J Am Coll Cardiol HF. 2022;10(12):948\u201359.","journal-title":"J Am Coll Cardiol HF"},{"key":"1573_CR4","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1253\/circj.CJ-23-0264","volume":"87","author":"T Imamura","year":"2023","unstructured":"Imamura T, Kinugawa K, Nishimura T, et al. Novel scoring system to risk stratify patients receiving durable left ventricular assist device from J-MACS registry data. Circ J. 2023;87:1103\u201311.","journal-title":"Circ J"},{"key":"1573_CR5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.xjtc.2023.10.012","volume":"23","author":"EM Schumer","year":"2024","unstructured":"Schumer EM, Bhatia P, Johnson T, et al. Surgically implanted endovascular microaxial left ventricular assist device support in cardiogenic shock patients. JTCVS Tech. 2024;23:1\u20137.","journal-title":"JTCVS Tech"},{"key":"1573_CR6","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1161\/CIRCULATIONAHA.122.062371","volume":"147","author":"ME Saad","year":"2023","unstructured":"Saad ME, Matthew R, Dirk W, Donker K, et al. Unloading the left ventricle in venoarterial ECMO: In whom, when, and how? Circulation. 2023;147:1237\u201350.","journal-title":"Circulation"},{"key":"1573_CR7","doi-asserted-by":"publisher","first-page":"3584","DOI":"10.1111\/jocs.16947","volume":"37","author":"MW Alex","year":"2022","unstructured":"Alex MW, Nicholas RT. Impella bridge to durable LVAD: a short run for a long slide. J Card Surg. 2022;37:3584\u20135.","journal-title":"J Card Surg"},{"key":"1573_CR8","doi-asserted-by":"publisher","first-page":"1379199","DOI":"10.3389\/fcvm.2024.1379199","volume":"11","author":"P Marina","year":"2024","unstructured":"Marina P, Alessandro O, Savino A, et al. Prolonged Impella 5.0\/5.5 support within different pathways of care for cardiogenic shock: the experience of a referral center. Front Cardiovasc Med. 2024;11:1379199.","journal-title":"Front Cardiovasc Med"},{"key":"1573_CR9","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1161\/CIRCHEARTFAILURE.113.000271","volume":"7","author":"H Takayama","year":"2014","unstructured":"Takayama H, Soni L, Kalesan B, et al. Bridge-to-decision therapy with a continuous-flow external ventricular assist device in refractory cardiogenic shock of various causes. Circ Heart Fail. 2014;7:799\u2013806.","journal-title":"Circ Heart Fail"}],"container-title":["Journal of Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10047-026-01573-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10047-026-01573-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10047-026-01573-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:03:18Z","timestamp":1789056198000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10047-026-01573-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["1573"],"URL":"https:\/\/doi.org\/10.1007\/s10047-026-01573-8","relation":{},"ISSN":["1434-7229","1619-0904"],"issn-type":[{"value":"1434-7229","type":"print"},{"value":"1619-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]},"assertion":[{"value":"25 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflict of interest.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This case was managed per the ethical standards of the Institute of Science Tokyo and the 1964 Declaration of Helsinki and its later amendments. Approval from the institutional ethics committee was not required for this type of case report, according to institutional policies. Written informed consent was obtained from the patient for the publication of this case report and the accompanying images. The patient\u2019s confidentiality and anonymity have been strictly protected, and no identifying information is included in the manuscript. A copy of the written consent is available for review by the Editor-in-Chief of this journal upon request.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"50"}}