Abstract
OBJECTIVE: Microaxial flow pumps are increasingly used in cardiogenic shock as a bridge to a permanent left ventricular assist device. Aortic valve insufficiency after left ventricular assist device implantation is a common complication impairing effective unloading of the left ventricle. Microaxial flow pumps may potentially damage the aortic valve and thus increase the risk of relevant aortic regurgitation during long-term left ventricular assist device support. The aim of this study was to evaluate the impact of microaxial flow pumps on the development of late aortic insufficiency after left ventricular assist device implantation. METHODS: In this retrospective single-center study, adult patients with a native aortic valve who received a left ventricular assist device between January 2015 and December 2021 were analyzed for aortic insufficiency by echocardiography before and at least 6 months after left ventricular assist device implantation (n = 291). Patients with moderate or severe aortic insufficiency requiring concomitant valve replacement at the time of the index procedure were excluded. Patients were divided into 2 groups: patients with (microaxial flow pump group) and without microaxial flow pumps (no microaxial flow pump group) support before left ventricular assist device implantation. Propensity score matching based on preoperative parameters resulted in well-balanced groups with 59 patients each. RESULTS: Overall, 20 patients (16.4%) developed moderate or severe aortic insufficiency during a median follow-up time of 665 (473-829) days. Patients with microaxial flow pumps before implantation of left ventricular assist device developed a moderate (8) or severe aortic insufficiency (3) in 18.6% of patients, whereas patients with no microaxial flow pumps before left ventricular assist device developed a moderate (9) or severe aortic insufficiency (0) in 15.3% of patients (paired odds ratio, 1.33; 95% CI, 0.46-3.84; P = .594). CONCLUSIONS: In this single-center retrospective analysis, microaxial flow pump support did not increase the risk for aortic valve insufficiency after durable left ventricular assist device implantation.