Cardiology

A Case Series Of Patients With Left Ventricular Assist Devices And Concomitant Mechanical Heart Valves.


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A Case Series Of Patients With Left Ventricular Assist Devices And Concomitant Mechanical Heart Valves.

Artif Organs. 2020 Apr 12;:

Authors: Al Saadi T, Andrade A, Chickerillo K, Joshi A, Sciamanna C, Pauwaa S, Macaluso G, Dia M, Cotts W, Tatooles A, Pappas P

Abstract
INTRODUCTION: Mechanical heart valves left in situ at the time of left ventricular assist device (LVAD) implantation are thought to potentially increase the risk of thromboembolism. Recommendations exist to replace dysfunctional mechanical mitral valves and any mechanical aortic valves at the time of LVAD implantation. Due to potential increases in cardiopulmonary bypass time and associated comorbidities with valve replacement, leaving a functional mechanical valve in place at LVAD implantation has been suggested to be a safe option.
METHODS: We retrospectively reviewed all patients with prior mechanical mitral or aortic valves undergoing LVAD implantation at our center between 2012 and 2017. Echocardiograms were read by a single cardiologist to assess for mechanical valve dysfunction.
RESULTS: We identified 15 patients. 5 patients had major bleeding requiring transfusion. On follow up, 2 patients had hemorrhagic stroke and 2 had transient ischemic attach/ischemic stroke. In addition, 2 patients had LVAD thrombosis and 2 patients had LVAD driveline malfunction. Mild mechanical valve regurgitation was identified on follow up echocardiograms of 2 patients.
CONCLUSION: Rate of complications in patients with mechanical valves undergoing LVAD implantation was comparable to those reported for the general LVAD population. Leaving a functional mechanical valve in place at the time of LVAD implantation could be a reasonable alternative to valve replacement. More data are required to further guide patient care in these individuals.

PMID: 32279355 [PubMed – as supplied by publisher]

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