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Aortic valve noncoronary cusp thrombosis after implantation of a nonpulsatile, continuous-flow pump

Zumrut T Demirozu1, O H Frazier

  • 1Department of Cardiovascular Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.

Texas Heart Institute Journal
|October 31, 2012
PubMed

Insights

Managing aortic valves in left ventricular assist device (LVAD) recipients is challenging. Thrombus formation on aortic valves, even with anticoagulation, highlights the need for standardized management strategies in these complex patients.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Cardiovascular Surgery

Background:

  • Left ventricular assist devices (LVADs) are crucial for end-stage heart failure management.
  • Standardization of anticoagulation protocols and pump-flow algorithms in LVAD recipients is lacking.
  • Management of native and prosthetic aortic valves in LVAD patients presents unique clinical challenges.

Observation:

  • This study details institutional experience with thrombotic complications in LVAD recipients.
  • Four cases of HeartMate II LVAD recipients developed aortic valve thrombosis.
  • Thrombus formation occurred on the noncoronary cusp of the aortic valve despite adherence to anticoagulative regimens.

Findings:

  • Aortic valve thrombosis is a significant complication in LVAD patients.
  • Current anticoagulation strategies may be insufficient to prevent aortic valve thrombus in all LVAD recipients.
  • The management of closed aortic valves in patients supported by LVADs remains a complex clinical issue.

Implications:

  • Findings underscore the need for improved and standardized approaches to aortic valve management in LVAD patients.
  • Further research is warranted to optimize anticoagulation and device management to mitigate thrombotic risks.
  • Developing effective strategies for aortic valve management is critical for improving outcomes in LVAD therapy.

Keywords:
Aortic valve/pathologyheart-assist devices/adverse effectsthrombosisventricular dysfunction, left

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