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Indian Journal of Thoracic and Cardiovascular Surgery
Erschienen in: Indian Journal of Thoracic and Cardiovascular Surgery 1/2023

20.07.2023 | Review Article

Managing valvular pathology during LVAD implantation

verfasst von: Michael J. Carr, Susan Ansley Smith, Mark S. Slaughter, Siddharth Pahwa

Erschienen in: Indian Journal of Thoracic and Cardiovascular Surgery | Sonderheft 1/2023

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Abstract

Since the time of their invention, implantable continuous flow left ventricular assist devices (LVADs) have improved the quality of life and extended survival for patients with advanced heart failure. The decision surgeons and their physician colleagues make with these patients to undergo implantation must come with full understanding of the immediate, short-term, and long-term implications of such a life-changing procedure. The presence of pathology regarding the aortic, mitral, and tricuspid valves introduces particularly complex problems for the surgical treatment strategy. Concomitant valve repair or replacement increases cardiopulmonary bypass and cross clamp times, and could potentially lead to worse outcomes in the perioperative setting. Following perioperative recovery, valvular pathology may worsen or arise de novo given the often drastic immediate physiologic changes in blood flow, septal function, and, over time, ventricular remodeling. Over the past two decades, there has been vast improvement in the device manufacturing, surgical techniques, and medical management surrounding LVAD implantation. Yet, addressing concomitant valvular pathology remains a complex question with no perfect solutions. This review aims to briefly describe the evolution of approach to valvular pathology in the LVAD patient and offer our opinion and treatment rationale.
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Metadaten
Titel
Managing valvular pathology during LVAD implantation
verfasst von
Michael J. Carr
Susan Ansley Smith
Mark S. Slaughter
Siddharth Pahwa
Publikationsdatum
20.07.2023
Verlag
Springer Nature Singapore
Erschienen in
Indian Journal of Thoracic and Cardiovascular Surgery / Ausgabe Sonderheft 1/2023
Print ISSN: 0970-9134
Elektronische ISSN: 0973-7723
DOI
https://doi.org/10.1007/s12055-023-01567-8

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