Aortic Insufficiency and Hemocompatibility-related Adverse Events in Patients with Left Ventricular Assist Devices

Teruhiko Imamura, Gene Kim, Daisuke Nitta, Takeo Fujino, Bryan Smith, Sara Kalantari, Ann Nguyen, Nikhil Narang, Luise Holzhauser, Jonathan Grinstein, Colleen Juricek, Daniel Rodgers, Tae Song, Takeyoshi Ota, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Aim: Hemocompatibility-related adverse events (HRAE) are a major cause of readmissions in patients with left ventricular assist devices (LVAD). The impact of aortic insufficiency (AI) on HRAE remains uncertain. We aimed to investigate the impact of AI on HRAE. Methods and Results: Patients who underwent LVAD implantation between August 2014 and July 2017 and had echocardiograms 3 months post-LVAD implantation were enrolled. AI severity was assessed by measuring the systolic/diastolic ratio of flow and the rate of diastolic flow acceleration using Doppler echocardiography of the outflow cannula. Regurgitation fraction was derived from these parameters. Significant AI was defined as regurgitation fraction > 30%. Among 105 patients (median age, 56 years; 76% male), 36 patients (34%) had significant AI. Baseline characteristics were statistically not significantly different between those with and without significant AI except for higher rates of ischemic etiology and atrial fibrillation in the significant AI group (P < 0.05 for both). One-year survival free from HRAE was 44% in patients with AI compared to 67% in patients without significant AI (P = 0.018). The average hemocompatibility score, which defines the net burden of HRAE, was higher in the AI group (1.72 vs 0.64; P = 0.009), due mostly to higher tier I (mild HRAE; P = 0.034) and tier IIIB scores (severe HRAE; P = 0.011). Conclusion: Significant AI, as assessed by Doppler echocardiographic parameters, was associated with HRAE during LVAD support.

Original languageEnglish
Pages (from-to)787-794
Number of pages8
JournalJournal of Cardiac Failure
Volume25
Issue number10
DOIs
Publication statusPublished - Oct 2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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