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Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Aortic Regurgitation I: Introduction01:15

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Heart Valves01:16

Heart Valves

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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
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Mitral Stenosis I: Introduction01:22

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Related Experiment Video

Updated: Aug 7, 2025

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
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Aortic valve disorders and left ventricular assist devices.

Deepak Acharya1, Toshinobu Kazui2, Dina Al Rameni2

  • 1Division of Cardiovascular Diseases, University of Arizona, Tucson, AZ, United States.

Frontiers in Cardiovascular Medicine
|March 13, 2023
PubMed
Summary

Aortic valve disorders, particularly aortic insufficiency (AI), significantly impact patients with left ventricular assist devices (LVADs). Early diagnosis and appropriate management are crucial for improving outcomes in advanced heart failure patients with LVADs.

Keywords:
advanced heart failureaortic insufficiencyaortic valveleft ventricular assist devicetranscatheter aortic valve replacement

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Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Devices

Background:

  • Aortic valve disorders, including aortic insufficiency (AI), are critical in patients with advanced heart failure undergoing evaluation for or already supported by left ventricular assist devices (LVADs).
  • AI can be pre-existing or develop de novo after LVAD implantation, often progressing and negatively affecting LVAD performance and heart failure symptoms.
  • Severe AI is linked to adverse hemodynamic changes, increased hospitalizations, and reduced survival rates in LVAD recipients.

Purpose of the Study:

  • To provide a comprehensive overview of the current diagnostic and management strategies for aortic valve disorders in patients with LVADs.
  • To highlight the challenges and evolving treatment options for both pre-existing and de novo AI in the context of LVAD therapy.

Main Methods:

  • Review of diagnostic modalities including echocardiography, device assessment, and catheterization.
  • Analysis of management strategies for pre-existing AI (aortic repair/replacement at LVAD implant).
  • Evaluation of treatment approaches for de novo AI, including surgical and percutaneous interventions like transcatheter aortic valve replacement (TAVR).

Main Results:

  • Standard echocardiographic criteria may be insufficient for accurately assessing AI severity in LVAD patients.
  • Management of de novo AI presents significant challenges due to increased risks associated with repeat interventions.
  • Percutaneous techniques, such as TAVR, are gaining importance in managing AI in LVAD patients.

Conclusions:

  • Accurate diagnosis and timely management of aortic valve disorders are essential for optimizing LVAD therapy outcomes.
  • The role of percutaneous interventions is expanding for managing AI in the complex LVAD population.
  • A multidisciplinary approach is necessary for addressing aortic valve issues in advanced heart failure patients with LVAD support.