Why the study?
Can a continuous flow LVAD be successfully used in a patient with mechanical mitral and aortic valve prostheses without valve replacement or exclusion?
Can a continuous flow LVAD be successfully used in a patient with mechanical mitral and aortic valve prostheses without valve replacement or exclusion?
Continuous flow LVAD can be successfully implanted as a bridge to transplant in patients with mechanical mitral and aortic valves without requiring valve explantation or exclusion.
Supports feasibility of continuous-flow LVAD without valve intervention in dual mechanical prostheses; hypothesis-generating and requires prospective validation before broader use.
In patients with left-sided mechanical aortic prostheses, it is recommended that the mechanical valve be replaced with a bioprosthesis, or excluded, at implantation of left ventricular assist device (LVAD). As changes in flow across the valve leads to potential thromboembolic complications, mechanical valves within the native heart are a relative contraindication to LVAD therapy. We here describe a patient who had long-standing valvular cardiomyopathy with mitral Starr-Edwards mechanical valve (Edwards Lifesciences, CA, USA) and aortic bileaflet tilting disc (St Jude Medical, St Paul, MN, USA) where LVAD was placed without explantation of the mechanical heart valves. The patient was bridged successfully to transplantation without thromboembolic events.
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Krishan et al. (2009) studied this question.
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