Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Nov 24:9:1068707.
doi: 10.3389/fcvm.2022.1068707. eCollection 2022.

Key questions about aortic insufficiency in patients with durable left ventricular assist devices

Eliza Calin  1 , Anique Ducharme  2 , Michel Carrier  1 , Yoan Lamarche  1 , Walid Ben Ali  1 , Pierre-Emmanuel Noly  1
Affiliations
Review

Key questions about aortic insufficiency in patients with durable left ventricular assist devices

Eliza Calin et al. Front Cardiovasc Med. .

Abstract

The development of the latest generation of durable left ventricular assist devices (LVAD) drastically decreased adverse events such as pump thrombosis or disabling strokes. However, time-related complications such as aortic insufficiency (AI) continue to impair outcomes following durable LVAD implantation, especially in the context of long-term therapy. Up to one-quarter of patients with durable LVAD develop moderate or severe AI at 1 year and its incidence increases with the duration of support. The continuous regurgitant flow within the left ventricle can compromise left ventricular unloading, increase filling pressures, decrease forward flow and can thus lead to organ hypoperfusion and heart failure. This review aims to give an overview of the epidemiology, pathophysiology, and clinical consequences of AI in patients with durable LVAD.

Keywords: aortic insufficiency; durable left ventricular assist devices; heart failure; mechanical circulatory support (MCS); pathophysiology; valvular heart disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Key answers about aortic insufficiency in patients with durable left ventricular assist device. Hemodynamic effects of left ventricular assist devices (LVAD) with aortic insufficiency. Adapted with permission from Noly et al. (53).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Shah P, Yuzefpolskaya M, Hickey GW, Breathett K, Wever-Pinzon O, Ton V-K, et al. Twelfth interagency registry for mechanically assisted circulatory support report: readmissions after left ventricular assist device. Ann Thorac Surg. (2022) 113:722–37. 10.1016/j.athoracsur.2021.12.011 - DOI - PMC - PubMed
    1. Doulamis IP, Inampudi C, Kourek C, Mandarada T, Kuno T, Asleh R, et al. Characteristics and outcomes of left ventricular assist device recipients transplanted before and after the new donor heart allocation system. Artif Organs. (2022). 10.1111/aor.14363 [Epub ahead of print]. - DOI - PubMed
    1. Mehra MR, Cleveland JC, Uriel N, Cowger JA, Hall S, Horstmanshof D, et al. Primary results of long-term outcomes in the MOMENTUM 3 pivotal trial and continued access protocol study phase: a study of 2200 HEARTMATE 3 left ventricular assist device implants. Eur J Heart Fail. (2021) 23:1392–400. 10.1002/ejhf.2211 - DOI - PMC - PubMed
    1. Mehra MR, Goldstein DJ, Cleveland JC, Cowger JA, Hall S, Salerno CT, et al. Five-year outcomes in patients with fully magnetically levitated vs axial-flow left ventricular assist devices in the MOMENTUM 3 randomized trial. JAMA. (2022) 328:1233. 10.1001/jama.2022.16197 - DOI - PMC - PubMed
    1. Bouabdallaoui N, El-Hamamsy I, Pham M, Giraldeau G, Parent M-C, Carrier M, et al. Aortic regurgitation in patients with a left ventricular assist device: a contemporary review. J Heart Lung Transplant. (2018) 37:1289–97. 10.1016/j.healun.2018.07.002 - DOI - PubMed

LinkOut - more resources