title: Prevalence of De Novo Aortic Valve Insufficiency in Patients After HeartWare VAD Implantation with an Intermittent Low-Speed Algorithm.
abstract: De novo aortic valve insufficiency (AI) is a frequent occurrence in patients supported with left ventricular assist device (LVAD). The European version of the HeartWare LVAD has intermittent low-speed software (lavare cycle) to facilitate intermittent aortic valve opening. We examined aortic valve opening status and prevalence of AI in patients supported with HeartWare LVAD and activated lavare cycle. HeartWare LVAD patients were prospectively monitored using serial echocardiograms at different time points after the LVAD implantation. Inclusion criteria were patients with no > mild AI and/or no aortic valve surgery at the time of LVAD implantation and at least 60 days of support. Three of 37 patients had aortic valve surgery and were excluded from the analysis. A total of 34 patients with mean age of 57 ± 12 years met the inclusion criteria. After median support duration of 408 days (77-1250 days), eight patients had trace/mild AI (24%) and one patient developed moderate AI (3%). An average pump flow, speed, and mean arterial pressure of 4.4 ± 0.6 L/min, 2,585 ± 147 rpm, and 88 ± 11 mmHg were documented, respectively. Aortic valve opening was persistently seen in 22 patients (65%). Aortic valve opening is frequent, and the development of > mild AI seems to be rare in patients supported with HeartWare LVAD.
authors.affiliation: From the *Medical Faculty, Clinic for Cardiovascular Surgery, University of Düsseldorf, Düsseldorf, Germany; and †Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: Diyar
authors.initials: D
authors.lastname: Saeed
authors.forename: Ralf
authors.initials: R
authors.lastname: Westenfeld
authors.forename: Bujar
authors.initials: B
authors.lastname: Maxhera
authors.forename: Stefanie
authors.initials: S
authors.lastname: Keymel
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sherif
authors.forename: Najla
authors.initials: N
authors.lastname: Sadat
authors.forename: GeorGI
authors.initials: G
authors.lastname: Petrov
authors.forename: Alexander
authors.initials: A
authors.lastname: Albert
authors.forename: Artur
authors.initials: A
authors.lastname: Lichtenberg
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001021:Aortic Valve / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012984:Software