title: Aortic valve noncoronary cusp thrombosis after implantation of a nonpulsatile, continuous-flow pump.
abstract: Different institutions have different strategies for managing both native and prosthetic aortic valves in recipients of left ventricular assist devices (LVADs). Anticoagulation protocols and pump-flow algorithms remain nonstandardized. We describe our institutional experience with thrombotic complications and our evolving approach to this important clinical problem. We report the cases of 4 HeartMate II LVAD recipients in whom, despite an anticoagulative regimen, thrombus formed on the noncoronary cusp of the aortic valve. The management of the closed aortic valve in LVAD-supported patients remains problematic.
authors.affiliation: Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
authors.forename: Zumrut T
authors.initials: ZT
authors.lastname: Demirozu
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D016027:Heart Transplantation; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017131:Thrombectomy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000925:Anticoagulants
keywords: Aortic valve/pathology; heart-assist devices/adverse effects; thrombosis; ventricular dysfunction, left