{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T21:45:05Z","timestamp":1776203105712,"version":"3.50.1"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Abiomed Europe GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Combined severe aortic regurgitation and severe mitral regurgitation is a condition associated with high mortality, where evidence, about proper management, is still scarce, especially in critical clinical conditions such as cardiogenic shock.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>An 86-year-old female with severe aortic and mitral regurgitation was admitted due to acute pulmonary oedema, rapidly deteriorating in cardiogenic shock refractory to medical treatment. Haemodynamic stabilization was achieved only after implantation of an Impella CP, through a trans-femoral approach. Considering the prohibitive surgical risk, the mitral valve regurgitation was treated with a transcatheter edge-to-edge repair procedure, which allowed to successfully wean the patient from Impella. Subsequently, a transcatheter aortic valve implantation was performed. The patient\u2019s clinical status improved to such a level that a rehabilitation program was successfully implemented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our report shows that an entirely percutaneous approach, to manage a combined severe aortic and mitral regurgitation, complicated by cardiogenic shock, is feasible and effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf185","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T07:05:31Z","timestamp":1744700731000},"source":"Crossref","is-referenced-by-count":1,"title":["Cardiogenic shock in a patient with combined severe aortic and mitral regurgitation treated by a totally percutaneous approach: a case report"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9334-2423","authenticated-orcid":false,"given":"Francesco","family":"Lo Iudice","sequence":"first","affiliation":[{"name":"Cardiology Department, S. Giovanni Di Dio E Ruggi D\u2019Aragona Hospital of Salerno , Largo Citt\u00e0 di Ippocrate, Salerno 84131 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amelia","family":"Ravera","sequence":"additional","affiliation":[{"name":"Cardiology Department, S. Giovanni Di Dio E Ruggi D\u2019Aragona Hospital of Salerno , Largo Citt\u00e0 di Ippocrate, Salerno 84131 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Campanile","sequence":"additional","affiliation":[{"name":"Cardiology Department, S. Giovanni Di Dio E Ruggi D\u2019Aragona Hospital of Salerno , Largo Citt\u00e0 di Ippocrate, Salerno 84131 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Romei","sequence":"additional","affiliation":[{"name":"Cardiology Department, S. Giovanni Di Dio E Ruggi D\u2019Aragona Hospital of Salerno , Largo Citt\u00e0 di Ippocrate, Salerno 84131 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Vigorito","sequence":"additional","affiliation":[{"name":"Cardiology Department, S. Giovanni Di Dio E Ruggi D\u2019Aragona Hospital of Salerno , Largo Citt\u00e0 di Ippocrate, Salerno 84131 ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"2025042603164894500_ytaf185-B1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"Vahanian","year":"2022","journal-title":"Eur Heart J"},{"key":"2025042603164894500_ytaf185-B2","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1161\/CIR.0000000000000932","article-title":"2020 ACC\/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"143","author":"Otto","year":"2021","journal-title":"Circulation"},{"key":"2025042603164894500_ytaf185-B3","doi-asserted-by":"crossref","first-page":"634","DOI":"10.4244\/EIJ-D-23-00473","article-title":"Transcatheter interventions for left-sided valvular heart disease complicated by cardiogenic shock: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) in collaboration with the Association for Acute Cardiovascular Care (ACVC) and the ESC Working Group on Cardiovascular Surgery","volume":"19","author":"Fraccaro","year":"2023","journal-title":"EuroIntervention"},{"key":"2025042603164894500_ytaf185-B4","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/ccd.28466","article-title":"One-stop-shop totally percutaneous approach for severe aortic and mitral regurgitation in cardiogenic shock","volume":"95","author":"Pagnotta","year":"2020","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025042603164894500_ytaf185-B5","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jacc.2020.05.051","article-title":"Concomitant mitral regurgitation in patients with chronic aortic regurgitation","volume":"76","author":"Yang","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2025042603164894500_ytaf185-B6","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.2459\/JCM.0000000000001280","article-title":"Impella implantation as a rescue strategy in balloon aortic valvuloplasty complicated by acute aortic regurgitation","volume":"23","author":"Ancona","year":"2022","journal-title":"J Cardiovasc Med (Hagerstown)"},{"key":"2025042603164894500_ytaf185-B7","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1016\/j.jacc.2012.02.020","article-title":"Transcatheter aortic valve replacement: outcomes of patients with moderate or severe mitral regurgitation","volume":"59","author":"Toggweiler","year":"2012","journal-title":"J Am Coll Cardiol"},{"key":"2025042603164894500_ytaf185-B8","doi-asserted-by":"crossref","first-page":"ytac370","DOI":"10.1093\/ehjcr\/ytac370","article-title":"Case series of transcatherter edge-to-edge repair using MitraClip\u2122 system with Impella\u00ae mechanical circulatory support","volume":"6","author":"Tanaka","year":"2022","journal-title":"Eur Heart J Case Rep"},{"key":"2025042603164894500_ytaf185-B9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12872-023-03667-0","article-title":"Transcatheter aortic valve implantation versus surgical aortic valve replacement for pure aortic regurgitation: a systematic review and meta-analysis of 33,484 patients","volume":"24","author":"Elkasaby","year":"2024","journal-title":"BMC Cardiovasc Disord"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf185\/62928205\/ytaf185.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/4\/ytaf185\/62928205\/ytaf185.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/4\/ytaf185\/62928205\/ytaf185.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T07:16:58Z","timestamp":1745651818000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf185\/8113388"}},"subtitle":[],"editor":[{"given":"Christoph","family":"Sinning","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Andreas","family":"Mitsis","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Levent","family":"Pay","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Piera","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,3,28]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,3,28]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf185","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4]]},"published":{"date-parts":[[2025,3,28]]},"article-number":"ytaf185"}}