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Updated: Jun 5, 2026
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Aortic valve closure associated with HeartMate left ventricular device support: technical considerations and
Robert M Adamson1, Walter P Dembitsky, Sam Baradarian
1Department of Cardiovascular Surgery, Sharp Memorial Hospital, San Diego, California 92123, USA. robandtl@aol.com
Summary
Closing the aortic outflow tract in patients with left ventricular assist devices (LVADs) is safe and improves survival. This procedure addresses aortic valve issues, enhancing LVAD support and patient outcomes.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Aortic valve integrity is essential for effective left ventricular assist device (LVAD) support.
- Aortic insufficiency and prosthetic valves pose significant challenges in LVAD patients.
- Maintaining optimal aortic valve function is critical for device performance and patient prognosis.
Purpose of the Study:
- To evaluate the safety and efficacy of left ventricular outflow tract closure in patients requiring LVAD support.
- To analyze indications, surgical techniques, and outcomes associated with aortic valve closure in the context of LVAD implantation or exchange.
- To compare survival rates of LVAD patients with and without aortic outflow tract closure.
Main Methods:
- Retrospective analysis of 28 patients undergoing outflow tract closure with HeartMate I/II LVADs.
- Review of indications for closure, surgical techniques, LVAD function, and complications.
- Comparison of survival rates with a control group of 104 LVAD patients without outflow tract closure.
Main Results:
- Indications included native aortic insufficiency, valve deterioration, and prosthetic valves.
- Actuarial survival was significantly better in the outflow closure group (78% at 1 year, 53% at 3 years) compared to controls.
- No regurgitation, embolization, or compromised LVAD function occurred post-closure; 2 operative and 5 late deaths were not attributed to the closure procedure.
Conclusions:
- Outflow tract closure is a safe and necessary procedure for select LVAD-supported patients.
- The technique is well-tolerated and associated with improved long-term survival.
- Aortic valve management through outflow tract closure enhances LVAD therapy effectiveness.
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