Aortic insufficiency during HeartMate 3 left ventricular assist device support
Imamura T, Narang N, Kim G, et al. Aortic insufficiency during heartmate 3 left ventricular assist device support. J Card Fail. 2020;26(10):863-869.
© 2020 Elsevier Inc. Background: Aortic insufficiency (AI) is associated with morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs), whereas its impact on the HeartMate 3 LVAD cohorts remains uninvestigated. We aimed to investigate the clinical impact of AI on patients with HeartMate 3 LVADs.
Methods and Results: Consecutive 61 patients (median age 54 years; 67% male) implanted with HeartMate 3 LVAD between 2015 and 2019 were enrolled and underwent echocardiography at 3 months after LVAD implantation. AI severity was quantified by the novel Doppler echocardiographic method obtained at the outflow cannula and the calculated regurgitation fraction of 30% or greater (moderate or greater) was defined as significant. At 3 months after implant, 12 patients (20%) had significant AI. They had a higher incidence of death or heart failure readmissions compared with those without significant AI during a 1-year observational period (70% vs 24%, P = .003) with an adjusted hazard ratio of 2.76 (95% confidence interval 1.03–7.88).
Conclusions: In patients with HeartMate 3 LVAD support, significant AI remains both prevalent and a clinically significant downstream complication.