title: Is a Bioprosthetic Valve in the Aortic Position Desirable with a Continuous Flow LVAD?
abstract: Commissural fusion of the native aortic valve in a patient with a continuous flow left ventricular assist device (LVAD) is a known phenomenon. This may result in aortic insufficiency (AI) leading to symptomatic heart failure. In patients with AI at the time of LVAD implantation, repairing, or replacing the aortic valve is advisable. We describe a patient who had a severe dilated cardiomyopathy and moderate AI who underwent implantation of an LVAD and aortic valve replacement with a bioprosthesis that subsequently developed commissural fusion which was found at the time of heart transplantation. This case highlights the conundrum of the management of AI in patients requiring LVAD support.
authors: Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Australia.
authors: Atsuo
authors: A
authors: Doi
authors: Silvana F
authors: SF
authors: Marasco
authors: David C
authors: DC
authors: McGiffin
mesh_terms: D000328:Adult; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D001705:Bioprosthesis; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery; D006333:Heart Failure / Q000150:complications / Q000601:surgery*; D016027:Heart Transplantation; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D011475:Prosthesis Failure