Natural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation
Natural history and clinical effect of aortic valve regurgitation after left ventricular assist device implantation
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DOI：
10.1016/j.jtcvs.2012.11.066
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发表时间：
2013-05-01
影响因子：
6
通讯作者：
Milano, Carmelo A.
中科院分区：
文献类型：
--
作者：
Rajagopal, Keshava;Daneshmand, Mani A.;Milano, Carmelo A.
目的：主动脉瓣反流降低了左心室辅助装置的机械效率。证据还表明，左心室辅助装置植入可诱发或加重主动脉瓣返流。然而，这还没有与非手术终末期心力衰竭人群中的主动脉瓣返流进展进行比较。此外，其临床效果尚不清楚。我们试图描述左心室辅助装置受体的主动脉瓣反流的发展和进展，并确定其临床效果。方法：回顾2004年1月至2011年1月在杜克大学医学中心接受腔内左心室辅助装置的所有连续患者。排除了既往或伴随主动脉瓣手术的病例。分析了剩余植入物（n = 184）和同期非手术终末期心力衰竭患者（n = 132）的数据。结果：左心室辅助装置的植入与主动脉瓣反流的加重（主动脉瓣反流分级增加）相关，与非手术治疗的终末期心力衰竭患者相比（P
Objectives: Aortic valve regurgitation reduces left ventricular assist device mechanical efficiency. Evidence has also suggested that left ventricular assist device implantation can induce or exacerbate aortic valve regurgitation. However, this has not been compared with aortic valve regurgitation progression in a nonsurgical end-stage heart failure population. Furthermore, its clinical effect is unclear. We sought to characterize the development and progression of aortic valve regurgitation in left ventricular assist device recipients and to identify its clinical effect.Methods: A review of all consecutive patients who received an intracorporeal left ventricular assist device at Duke University Medical Center from January 2004 to January 2011 was conducted. Cases of previous or concomitant aortic valve surgery were excluded. Data from the remaining implants (n = 184) and a control group of contemporaneous nonsurgical patients with end-stage heart failure (n = 132) were analyzed. Serial transthoracic echocardiography was used to characterize aortic valve regurgitation as a function of time.Results: Left ventricular assist device implantation was associated with worsening aortic valve regurgitation, defined as an increase in aortic valve regurgitation grade, relative to the nonsurgical patients with end-stage heart failure (P