Key result
Continuous-flow left ventricular assist devices alter cardiovascular physiology and can induce progression of preexisting valvular heart disease or lead to de novo valvular heart disease.
Continuous-flow LVADs alter cardiovascular physiology and can cause progression or de novo development of valvular heart disease, necessitating specific management recommendations.
May prompt closer valvular monitoring in LVAD recipients; leaves open optimal prevention and intervention strategies.
Patients with advanced HF and coexisting VHD who undergo LVAD implantation constitute a growing population and pose unique challenges in clinical and surgical management. Contemporary continuous-flow LVADs alter blood flow dynamics and cardiovascular physiology and can induce progression of preexisting VHD or lead to de novo VHD. Although we have defined our recommendations for treatment options (Table 2), continued changes to device technology, patient selection, and surgical techniques will undoubtedly lead to further changes in practice. Finally, the rapid growth in the field of mechanical circulatory support necessitates collaborative multicenter approaches to study the impact of these practice changes in the form of prospective randomized trials.
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Wang et al. (2014) conducted a review in Advanced heart failure with coexisting valvular heart disease. Left Ventricular Assist Devices (LVAD) was evaluated. Continuous-flow left ventricular assist devices alter cardiovascular physiology and can induce progression of preexisting valvular heart disease or lead to de novo valvular heart disease.
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