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Echocardiographic evaluation of ‘sandwich plug’ closure of mechanical aortic valve at left ventricular assist device implantation
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A 67-year-old man with a history of non-ischaemic cardiomyopathy (ejection fraction 15%–20%) and previous mechanical aortic valve replacement presented for HeartMate II left ventricular assist device (LVAD) implantation due to worsening heart failure symptoms (New York Heart Association III–IV). After redo sternotomy, the aortic valve was closed with a prefashioned occluder device (figure 1). After occluder placement, the aortic cross-clamp was removed and the valve assessed with transoesophageal echocardiography (TOE) to ensure proper closure (figures 2–4, videos 1–3). Once satisfactory closure was confirmed, a HeartMate II LVAD was inserted.