Shaanxi team uses ECMO support for high-risk transcatheter aortic valve replacement
Shaanxi Provincial People’s Hospital reports TAVR in a 76-year-old with severe aortic stenosis and an ejection fraction of 29%, using ECMO for circulatory support.
Published by CareAtlas · Editorial policy
Shaanxi Provincial People’s Hospital has reported transcatheter aortic valve replacement (TAVR) with extracorporeal membrane oxygenation (ECMO) circulatory support in a 76-year-old patient with severe aortic stenosis. The patient had repeatedly been admitted for chest tightness, breathlessness and nighttime breathing distress, with recurrent heart failure. Left ventricular ejection fraction had fallen to 29%, indicating severely impaired pumping function.
A valve procedure with planned circulatory support
Examination showed severe aortic stenosis with regurgitation. The valve was thickened and calcified, with a peak velocity of 4.2 m/s and a maximum transvalvular pressure gradient of 71 mmHg. A sharply angulated aortic arch, calcification at multiple sites in the major vessels and thrombus added to the risks.
The hospital considered conventional surgery extremely high risk. Maintaining stable circulation during manipulation of the valve was a particular concern because circulatory collapse could occur. After multidisciplinary discussion, Cardiology Department III and the collaborating teams selected TAVR through the femoral artery with ECMO support.
What happened during the operation
The team first established ECMO life support. Using the right femoral artery as the main access route, it performed aortic root angiography, passed a guidewire across the valve and carried out balloon predilatation before deploying the prosthetic valve.
Immediate transoesophageal echocardiography showed that the new valve was functioning well. Transvalvular velocity measured 148 cm/s, and the pressure gradient fell to 9 mmHg. The hospital reported a marked improvement in haemodynamics and completion of the operation.
The report, published on October 19, 2026, illustrates how a valve intervention and mechanical circulatory support were combined after assessment of several interacting risks. For patients considering an opinion on complex valve disease, its practical value lies in the documented assessment and procedural strategy. The results described are immediate findings from one case; the article does not establish a discharge outcome, longer-term survival or suitability of the same approach for other patients.