Moderate Aortic Insufficiency with a Left Ventricular Assist Device Portends a Worse Long-Term Survival.
Publication/Presentation Date
7-1-2020
Abstract
The development of aortic insufficiency (AI) is known to be associated with prolonged left ventricular assist device (LVAD) support, but its overall significance with regards to long-term outcomes is unclear. This uncertainty translates to a lack of consensus regarding the management of AI in this patient population-an increasingly pertinent question as more patients are placed on LVAD support as destination therapy. A retrospective review of a single, high-volume institution was performed to assess outcomes in patients who received a HeartMate II or HeartWare (LVAD) between 2008 and 2018. Patients were stratified by AI severity at 6 months, and those with LVAD support of less than 6 months were excluded. The primary endpoint was 2 year mortality, and secondary endpoints were right heart failure and functional exercise capacity. At 6 month follow-up 111, 92, and 18 patients had no (0), mild (1), and moderate (2) AI, respectively. Moderate AI was a significant predictor of 2 year mortality in a multivariable model (p = 0.024). Functional exercise capacity (measured by 6 minute walk test) and incidence of right heart failure at 1 year were not significantly different between groups (P = 0.1421; P = 0.2189). In conclusion, moderate AI at 6 months post-LVAD implant is associated with worse long-term mortality. More aggressive management strategies targeting AI development in long-term LVAD patients may be warranted.
Volume
66
Issue
7
First Page
780
Last Page
785
ISSN
1538-943X
Published In/Presented At
Auvil, B., Chung, J., Ameer, A., Han, J., Helmers, M., Birati, E., Acker, M., & Atluri, P. (2020). Moderate Aortic Insufficiency with a Left Ventricular Assist Device Portends a Worse Long-Term Survival. ASAIO journal (American Society for Artificial Internal Organs : 1992), 66(7), 780–785. https://doi.org/10.1097/MAT.0000000000001071
Disciplines
Medicine and Health Sciences
PubMedID
31567420
Department(s)
Department of Medicine
Document Type
Article
