Aortic insufficiency in patients with sustained left ventricular systolic dysfunction after axial flow assist device implantation

Teruhiko Imamura, Koichiro Kinugawa, Takeo Fujino, Toshiro Inaba, Hisataka Maki, Masaru Hatano, Osamu Kinoshita, Kan Nawata, Shunei Kyo, Minoru Ono

研究成果: Contribution to journalArticle査読

30 被引用数 (Scopus)

抄録

Background: Predicting the occurrence of aortic insufficiency (AI) during left ventricular assist device (LVAD) support has remained unsolved.

Methods and Results: We enrolled 52 patients who had received continuous flow LVAD (14 axial and 38 centrifugal pumps) and who been followed for >6 months between Jun 2006 and Dec 2013. Native aortic valve (AV) opening was observed in 18 patients (35%) with improved LV systolic function, and none of them had AI. On multivariate logistic regression analysis preoperative shorter heart failure duration was the only independent predictor of postoperative native AV opening (P=0.042; odds ratio [OR], 0.999). Of the remaining 34 patients (65%) with closed AV, 11 had AI with enlargement of the aortic root and narrow pulse pressure. Among those with closed AV, axial pump use (n=13) was the only significant predictor of the development of AI (P=0.042; OR, 4.950). Patients with AI had lower exercise capacity and a higher readmission rate than those without AI during 2-year LVAD support (55% vs. 8%; P<0.001).

Conclusions: Native AV opening during LVAD support is profoundly associated with reversal of LV systolic function, especially in patients with preoperative shorter heart failure duration. Among those in whom the native AV remains closed, low pulsatility of axial flow pump may facilitate aortic root remodeling and post-LVAD AI development that results in worse clinical outcome. (Circ J 2015; 79: 104-111)

本文言語英語
ページ(範囲)23-41
ページ数19
ジャーナルCirculation Journal
79
1
DOI
出版ステータス出版済み - 12 19 2014
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

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