Aortic Insufficiency During HeartMate 3 Left Ventricular Assist Device Support

J Card Fail. 2020 Oct;26(10):863-869. doi: 10.1016/j.cardfail.2020.05.013. Epub 2020 May 27.


Background: Aortic insufficiency (AI) is associated with morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs), whereas its impact on the HeartMate 3 LVAD cohorts remains uninvestigated. We aimed to investigate the clinical impact of AI on patients with HeartMate 3 LVADs.

Methods and results: Consecutive 61 patients (median age 54 years; 67% male) implanted with HeartMate 3 LVAD between 2015 and 2019 were enrolled and underwent echocardiography at 3 months after LVAD implantation. AI severity was quantified by the novel Doppler echocardiographic method obtained at the outflow cannula and the calculated regurgitation fraction of 30% or greater (moderate or greater) was defined as significant. At 3 months after implant, 12 patients (20%) had significant AI. They had a higher incidence of death or heart failure readmissions compared with those without significant AI during a 1-year observational period (70% vs 24%, P = .003) with an adjusted hazard ratio of 2.76 (95% confidence interval 1.03-7.88).

Conclusions: In patients with HeartMate 3 LVAD support, significant AI remains both prevalent and a clinically significant downstream complication.

Keywords: heart failure; hemodynamic; regurgitation.

MeSH terms

  • Aortic Valve Insufficiency* / diagnostic imaging
  • Aortic Valve Insufficiency* / epidemiology
  • Aortic Valve Insufficiency* / etiology
  • Child, Preschool
  • Echocardiography
  • Echocardiography, Doppler
  • Female
  • Heart Failure* / therapy
  • Heart-Assist Devices* / adverse effects
  • Humans
  • Male
  • Retrospective Studies