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Updated: Nov 21, 2025
08:49
Use of Two Intracorporeal Ventricular Assist Devices As a Total Artificial Heart
Published on: May 11, 2018
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Secondary aortic valve replacement in continuous flow left ventricular assist device therapy
Takayuki Gyoten1, Michiel Morshuis1, Henrik Fox1
1Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre North Rhine Westphalia, Bad Oeynhausen, Germany.
Artificial Organs
|January 12, 2021
Summary
Secondary surgical aortic valve replacement (sSAVR) in patients with ventricular assist devices (VAD) is effective but carries a high risk of right heart failure. This advanced procedure can be a salvage option for select VAD patients needing aortic valve replacement.
Area of Science:
- Cardiology
- Cardiac Surgery
- Mechanical Circulatory Support
Background:
- Severe aortic regurgitation (AR) poses challenges in patients with continuous-flow ventricular assist devices (cf-LVAD).
- Secondary surgical aortic valve replacement (sSAVR) is an option when transcatheter aortic valve replacement (TAVR) is not feasible.
Purpose of the Study:
- To investigate the outcomes of sSAVR in patients with severe AR on cf-LVAD support.
- To assess the safety and efficacy of sSAVR in this complex patient cohort.
Main Methods:
- Retrospective analysis of 792 cf-LVAD implantations from 2009-2020.
- Identified six patients who underwent sSAVR after cf-LVAD implantation.
- Documented concomitant procedures, outcomes, and need for further interventions.
Main Results:
- Six patients (median age 40 years) underwent sSAVR after a median of 26 months of LVAD support.
- Two patients required tricuspid valve repair; one had sSAVR after TAVR failure.
- Four patients needed temporary right ventricular assist device (RVAD); three were bridged to heart transplantation due to right heart failure.
Conclusions:
- sSAVR is a feasible and effective salvage procedure for select LVAD patients with severe AR where TAVR is not an option.
- The procedure carries a significant risk of subsequent right heart failure, often necessitating urgent heart transplantation.
- sSAVR can be considered for bridge-to-transplant candidates or carefully selected destination therapy patients.
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