PAPERS

Inflow valve regurgitation during LVAD support may interfere with reverse ventricular remodeling

N Moazami, M Argenziano, T Kohmoto, S Yazdani, EA Rose, D Burkhoff and MC Oz
The Annals of Thoracic Surgery 1998;65:628-631

BACKGROUND.  Left ventricular assist devices have been reported previously to reverse ventricular remodeling in patients with dilated cardiomyopathy.  In patients with prolonged mechanical support, structural failure of the left ventricular assist device inflow valve can cause regurgitation into the left ventricle, which may affect adversely this process.  METHODS.  Left ventricular end-diastolic pressure-volume relations of hearts explanted from 8 patients with left ventricular assist device and 8 control subjects with idiopathic cardiomyopathy were determined ex vivo at the time of transplantation.  RESULTS:  Duration of mechanical support range from 210 to 276 days in 3 patients with inflow valve regurgitation versus 100 to 155 days in 5 patients without.  The end-diastolic pressure-volume relation of all hearts supported mechanically was shifted to the left toward normal controls.  This effect was markedly attenuated in patients with inflow valve regurgitation.  CONCLUSIONS:  Mechanical assistance can cause reverse remodeling in patients with dilated cardiomyopathy as evidenced by the shift in the end-diastolic pressure-volume relations curve to the left.  Inflow valve failure, associated with prolonged support, can attenuation changes in left ventricular structure and dimension.  Ineffective pressure and volume unloading may explain these observations.


    
                                        
                    

Tags: ,

Download Full Paper

« Back to Papers