The Challenges of Aortic Valve Management After Left Ventricular Assist Device Implantation.
Publication/Presentation Date
9-1-2024
Abstract
BACKGROUND: Continuous retrograde flow across the aortic valve from left ventricular assist device (LVAD) therapy can result in cusp damage and progressive aortic regurgitation, potentially triggering recurrent heart and multiorgan failure. The management of aortic regurgitation after LVAD implantation has not been well defined.
METHODS: This study retrospectively reviewed the investigators' experience with the management of de novo aortic regurgitation requiring intervention in patients with continuous-flow LVAD.
RESULTS: Six patients who had undergone LVAD implantation and who required intervention were identified. Two patients underwent redo sternotomy with bioprosthetic aortic valve replacement, and 4 patients underwent percutaneous management, including Amplatzer device (Abbott) placement and transcatheter aortic valve replacement. All patients had resolution of aortic regurgitation with improved hemodynamics and relief from heart failure. One early and 2 late deaths occurred. Valve function was intact, with all valves opening intermittently without greater than trivial aortic regurgitation.
CONCLUSIONS: Multiple treatment modalities exist for LVAD-induced aortic valve regurgitation, including open surgical and percutaneous strategies. With a tailored risk-adjusted approach, acceptable results may be achieved.
Volume
2
Issue
3
First Page
567
Last Page
572
ISSN
2772-9931
Published In/Presented At
Pitoulis, F., Tauber, K., Atluri, P., Szeto, W., Anwarruddin, S., Kobayashi, T., Desai, N., Cevasco, M., Bermudez, C., Acker, M., Williams, M., & Ibrahim, M. (2024). The Challenges of Aortic Valve Management After Left Ventricular Assist Device Implantation. Annals of thoracic surgery short reports, 2(3), 567–572. https://doi.org/10.1016/j.atssr.2024.04.028
Disciplines
Medicine and Health Sciences
PubMedID
39790404
Department(s)
Department of Surgery
Document Type
Article