Q: Which valve abnormality is common after insertion of continuous Left Ventricular Assist Device (LVAD)? 


Answer:  Aortic regurgitation 

 New aortic regurgitation may occur in about one fourth of patients who receives LVAD.  It may become clinically symptomatic requiring surgical fix. Temporary fix is to increase the speed of LVAD up to the point where aortic valve opening is observed under echocardiogram. This is recommended under the assumption that most aortic regurgitation after LVAD occurs in patients whose aortic valve stays closed. But permanent treatment is via surgery. Prophylactic stitch procedure at the time of LVAD insertion has also been proposed to avoid aortic regurgitation later.



References:

1.  Pak SW, Uriel N, Takayama H, et al. Prevalence of de novo aortic insufficiency during long-term support with left ventricular assist devices. J Heart Lung Transplant 2010; 29:1172.

2. Cowger J, Pagani FD, Haft JW, et al. The development of aortic insufficiency in left ventricular assist device-supported patients. Circ Heart Fail 2010; 3:668.