Management of Aortic Valve Insufficiency in Patients Supported By Long-Term Continuous Flow Left Ventricular Assist Devices

• Published in: The Annals of thoracic surgery Vol. 94; no. 5; pp. 1710 - 1712
• Main Authors: Morgan, Jeffrey A., MD, Brewer, Robert J., MD, Nemeh, Hassan W., MD, Henry, Scott E., MD, Neha, Narula, BA, Williams, Celeste T., MD, Lanfear, David E., MD, Tita, Cristina, MD, Paone, Gaetano, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-11-2012; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aortic Valve Insufficiency - surgery; Biological and medical sciences; Cardiology. Vascular system; Cardiothoracic Surgery; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Endocardial and cardiac valvular diseases; Female; Heart; Heart-Assist Devices; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; Pneumology; Surgery; Time Factors; 27; Artificial heart; Human; Intensive cardiocirculatory care; Support; Continuous; Artificial ventricle; Cardiocirculatory support; Cardiovascular disease; Patient; Aortic regurgitation; Long term; Clinical management; Cardiac valvular disease; Auxiliary ventricule; Anesthesia; Circulatory system; Cardiology; Aortic valve
• ISSN: 0003-4975; 1552-6259
• DOI: 10.1016/j.athoracsur.2012.03.105

Continuous flow (CF) left ventricular assist devices (LVADs) have yielded improved outcomes in patient survival and quality of life compared with first-generation pulsatile pumps; however, they have been associated with an increased incidence of postimplant aortic valve insufficiency (AI), which can have can have serious clinical consequences if not diagnosed and treated expeditiously. We reviewed our experience with AI after LVAD since the start of our CF LVAD program. From March 2006 through July 2011, 94 patients with chronic heart failure underwent implantation of a HeartMate II (HM II) LVAD. Severe AI developed in three patients after CF LVAD implantation. The clinical records of these patients were reviewed to analyze the presenting signs and symptoms of AI, identify the duration of LVAD support when the AI occurred, how the AI was treated, and the outcomes.