Document Detail


Less frequent opening of the aortic valve and a continuous flow pump are risk factors for postoperative onset of aortic insufficiency in patients with a left ventricular assist device.
MedLine Citation:
PMID:  21378448     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Postoperative development of aortic insufficiency (AI) after implantation of left ventricular assist devices (LVADs) has recently been recognized, but the devices in the previous reports have been limited to the HeartMate I or II. The purposes of this study were to determine whether AI develops with other types of LVADs and to elucidate the factors associated with the development of AI.
METHODS AND RESULTS: Thirty-seven patients receiving LVADs without evident abnormalities in native aortic valves were enrolled (pulsatile flow LVAD [TOYOBO]: 76%, continuous flow LVAD [EVAHEART, DuraHeart, Jarvik2000, HeartMate II]: 24%). Frequency of aortic valve opening and grade of AI were evaluated by the most recent echocardiography during LVAD support. None of the patients had more than trace AI preoperatively. During LVAD support AI >- grade 2 developed in 9 patients (24%) across all 5 types of devices. More severe grade of AI correlated with higher plasma B-type natriuretic peptide concentration (r = 0.53, P < 0.01) and with less frequent of the aortic valve (r = 0.45, P < 0.01). Multivariate analysis revealed that lower preoperative left ventricular ejection fraction and a continuous flow device type were independent risk factors for higher incidence of AI.
CONCLUSIONS: AI, which is hemodynamically significant, develops after implantation of various types of LVADs. Physicians need to be more alert to the development of AI particularly with continuous flow devices.
Authors:
Masaru Hatano; Koichiro Kinugawa; Taro Shiga; Naoko Kato; Miyoko Endo; Motoyuki Hisagi; Takashi Nishimura; Atsushi Yao; Yasunobu Hirata; Shunei Kyo; Minoru Ono; Ryozo Nagai
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Publication Detail:
Type:  Journal Article     Date:  2011-03-03
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-04-25     Completed Date:  2011-09-29     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1147-55     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aortic Valve / physiopathology*
Aortic Valve Insufficiency / diagnosis*,  etiology*
Female
Heart-Assist Devices / adverse effects*
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Postoperative Period
Prosthesis Implantation / adverse effects*
Risk Factors
Stroke Volume

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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