Percutaneous continuous aortic flow augmentation for cardiac recovery in a chronic heart failure patient with peripheral vascular disease.

Peripheral vascular disease is an obstacle to the use of continuous aortic flow augmentation (CAFA). The authors used CAFA in a patient with a 50% stenosis of the left iliac artery. Five hours after initiating therapy, flow rates dropped from 1.47 L/min to 0.2 L/min, possibly due to obstruction around the inflow cannula near the site of the iliac artery stenosis. Flow was stabilized by adequate fluid infusion and successfully restored by slightly withdrawing the tip of the inflow catheter. This finding suggests that peripheral vascular disease is a relative—not an absolute—contraindication for CAFA, but requires close monitoring of flow during CAFA therapy.