title: Management of aortic valve insufficiency in patients supported by long-term continuous flow left ventricular assist devices.
abstract: Continuous flow (CF) left ventricular assist devices (LVADs) have yielded improved outcomes in patient survival and quality of life compared with first-generation pulsatile pumps; however, they have been associated with an increased incidence of postimplant aortic valve insufficiency (AI), which can have can have serious clinical consequences if not diagnosed and treated expeditiously. We reviewed our experience with AI after LVAD since the start of our CF LVAD program. From March 2006 through July 2011, 94 patients with chronic heart failure underwent implantation of a HeartMate II (HM II) LVAD. Severe AI developed in three patients after CF LVAD implantation. The clinical records of these patients were reviewed to analyze the presenting signs and symptoms of AI, identify the duration of LVAD support when the AI occurred, how the AI was treated, and the outcomes.
authors.affiliation: Division of Cardiothoracic Surgery, Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI 48202, USA. jmorgan2@hfhs.org
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Morgan
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Brewer
authors.forename: Hassan W
authors.initials: HW
authors.lastname: Nemeh
authors.forename: Scott E
authors.initials: SE
authors.lastname: Henry
authors.forename: Narula
authors.initials: N
authors.lastname: Neha
authors.forename: Celeste T
authors.initials: CT
authors.lastname: Williams
authors.forename: David E
authors.initials: DE
authors.lastname: Lanfear
authors.forename: Cristina
authors.initials: C
authors.lastname: Tita
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paone
mesh_terms: D001022:Aortic Valve Insufficiency / Q000601:surgery*; D005260:Female; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors