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Left ventricular outflow tract obstruction associated with chronic ventricular assist device support
Sam Baradarian1, Walter P Dembitsky, Brian Jaski
1Sharp Memorial Hospital, San Diego CA 92123, USA.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|November 29, 2002
Summary
Left ventricular assist device (LVAD) use can lead to aortic valve cusp fusion, potentially causing complications like emboli and infection. This fusion may hinder heart recovery and weaning from LVAD support.
Area of Science:
- Cardiology
- Medical Devices
- Pathophysiology
Background:
- Left ventricular assist devices (LVADs) improve outcomes for end-stage cardiomyopathy.
- Pathophysiological changes can adversely affect long-term LVAD patient outcomes.
- Aortic valve cusp fusion is a potential complication of chronic LVAD support.
Purpose of the Study:
- To investigate the incidence and implications of aortic valve cusp fusion in patients with LVADs.
- To assess the impact of aortic valve cusp fusion on myocardial recovery and LVAD weaning.
Main Methods:
- Retrospective review of 33 LVAD placements.
- Analysis of operative reports and pathological examinations of explanted native hearts.
- Assessment of aortic valve morphology and left ventricular outflow tract status.
Main Results:
- Aortic valve cusp fusion was observed in 7 out of 33 patients (approximately 21%) after chronic LVAD support.
- Fusion occurred in patients with both native and bioprosthetic aortic valves.
- Potential complications include embolic events, infection, and left ventricular outflow tract obstruction.
Conclusions:
- Aortic valve cusp fusion is a notable complication in patients with LVADs.
- This fusion can pose risks such as emboli and infection.
- It may impede myocardial recovery and successful weaning from LVAD support due to outflow tract obstruction.