Rehabilitation Course Through Compassionate Use of JenaValve Trilogy Heart Valve System in a Patient With Left Ventricular Assist Device: A Case Study.
Kara Eid, Peyton Conti, Tim Robbins
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Case in brief
A 47-year-old man with a destination HeartMate 3 LVAD developed methicillin-susceptible Staphylococcus aureus bacteremia and severe aortic insufficiency, leading to cardiogenic shock. Despite inotropic and pharmacologic support, he became profoundly deconditioned and had fluctuating renal and hepatic function. Following multidisciplinary review, he received a JenaValve Trilogy under compassionate use. After the procedure, his function improved from requiring maximal assistance to independent ambulation; he walked 1,145 feet on the 6-minute walk test and scored 24/24 on the Activity Measure Post-Acute Care Basic Mobility scale.
What made this case unusual
The Trilogy Valve was used under compassionate use to treat severe aortic insufficiency in an LVAD recipient, a setting in which transcatheter valve use remains limited.
Diagnostic / clinical pearl
In an LVAD recipient with severe aortic insufficiency and cardiogenic shock, multidisciplinary assessment may identify compassionate-use transcatheter valve replacement as an option; this case also documents substantial functional recovery after the procedure.
Why it matters
The case highlights the need for further registry data and research on procedural standardization, hemodynamic effects, and rehabilitation outcomes in this high-risk population.