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Aortic Insufficiency Causes Symptomatic Heart Failure during Left Ventricular Assist Device Support
Masaaki Naganuma1, Masatoshi Akiyama1, Konosuke Sasaki1
1Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine.
The Tohoku Journal of Experimental Medicine
|November 18, 2021
Summary
De novo aortic insufficiency in patients with left ventricular assist devices (LVADs) did not impact long-term mortality but significantly increased the risk of symptomatic heart failure events after implantation.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Research
Background:
- De novo aortic insufficiency (AI) is a common complication during long-term left ventricular assist device (LVAD) support.
- The impact of AI on mortality and symptomatic heart failure in LVAD patients remains unclear.
Purpose of the Study:
- To investigate the influence of de novo AI development on long-term mortality and symptomatic heart failure in patients receiving LVAD support.
Main Methods:
- Retrospective analysis of 53 patients undergoing durable LVAD implantation.
- Echocardiographic assessment of AI grading post-discharge.
- Kaplan-Meier survival analysis and logistic regression for risk factor identification.
Main Results:
- No significant difference in long-term mortality was observed between patients with severe/moderate AI (grade ≥ 3) and those with mild/none (grade < 3).
- AI was independently associated with an increased risk of symptomatic heart failure events post-discharge (OR, 4.12; 95% CI, 1.48-16.93; P = 0.005).
- AI progression correlated with symptomatic heart failure.
Conclusions:
- De novo aortic insufficiency in LVAD patients is not linked to increased long-term mortality.
- AI development is an independent risk factor for symptomatic heart failure in LVAD recipients.
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