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Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device.

Publication ,  Journal Article
Mudd, JO; Cuda, JD; Halushka, M; Soderlund, KA; Conte, JV; Russell, SD
Published in: J Heart Lung Transplant
December 2008

BACKGROUND: Left ventricular assist devices (LVADs) are an important therapy for selected individuals with advanced heart failure unable to wait for a suitable donor for transplantation. Pulsatile LVADs are associated with commissural fusion of the aortic valve, yet little is known about this association with newer generation continuous axial flow LVADs. METHODS: We retrospectively reviewed pathologic samples from 9 patients enrolled in the HeartMate II Bridge to Transplantation Trial. Echocardiograms at 1, 6 and 12 months after device placement were evaluated for aortic valve opening and aortic insufficiency. At the time of transplantation, explanted hearts were examined for gross pathologic valvular abnormalities and histologic analysis. RESULTS: All but 1 explant had evidence of commissural fusion of the native aortic valve leaflets. Over time there was a decreasing prevalence of aortic valve opening and an increasing prevalence of mild to moderate aortic insufficiency independent of pump speed. All patients had improvements in their functional status and were successfully bridged to orthotopic heart transplantation. CONCLUSIONS: Commissural fusion of the native aortic valve leaflets occurs frequently with an increasing prevalence of aortic insufficiency during continuous flow LVAD support. With the potential broader use of non-pulsatile LVADs and the prospect of using LVADs as means to assist in myocardial recovery, special attention should be given to evaluating aortic valve function during LVAD support.

Duke Scholars

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

December 2008

Volume

27

Issue

12

Start / End Page

1269 / 1274

Location

United States

Related Subject Headings

  • Time Factors
  • Surgery
  • Retrospective Studies
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Ventricles
  • Heart Transplantation
  • Heart Failure
 

Citation

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ICMJE
MLA
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Mudd, J. O., Cuda, J. D., Halushka, M., Soderlund, K. A., Conte, J. V., & Russell, S. D. (2008). Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device. J Heart Lung Transplant, 27(12), 1269–1274. https://doi.org/10.1016/j.healun.2008.05.029
Mudd, James O., Jonathan D. Cuda, Marc Halushka, Karl A. Soderlund, John V. Conte, and Stuart D. Russell. “Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device.J Heart Lung Transplant 27, no. 12 (December 2008): 1269–74. https://doi.org/10.1016/j.healun.2008.05.029.
Mudd JO, Cuda JD, Halushka M, Soderlund KA, Conte JV, Russell SD. Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device. J Heart Lung Transplant. 2008 Dec;27(12):1269–74.
Mudd, James O., et al. “Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device.J Heart Lung Transplant, vol. 27, no. 12, Dec. 2008, pp. 1269–74. Pubmed, doi:10.1016/j.healun.2008.05.029.
Mudd JO, Cuda JD, Halushka M, Soderlund KA, Conte JV, Russell SD. Fusion of aortic valve commissures in patients supported by a continuous axial flow left ventricular assist device. J Heart Lung Transplant. 2008 Dec;27(12):1269–1274.
Journal cover image

Published In

J Heart Lung Transplant

DOI

EISSN

1557-3117

Publication Date

December 2008

Volume

27

Issue

12

Start / End Page

1269 / 1274

Location

United States

Related Subject Headings

  • Time Factors
  • Surgery
  • Retrospective Studies
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Heart Ventricles
  • Heart Transplantation
  • Heart Failure