Aortic Regurgitation After Left Ventricular Assist Device Placement

Abstract

A 1 60-YEAR-OLD man with a history of recent heart failure caused by both primitive and ischemic dilated cardiomypathy underwent the successful implantation of a left ventriclar assist device (Novacor LVAS; WorldHeart, Ottawa, ON, anada) under cardiopulmonary bypass. Intraoperative transsophageal echocardiography (TEE) performed immediately fter implantation showed the correct placement of both the nflow and the outflow grafts (Fig 1) and the absence of any ortic regurgitation or aortic valve pathology. His immediate postoperative course was uneventful, and no ight ventricular assistance was needed. A routine follow-up ransthoracic echocardiogram performed in the intensive care nit on postimplantation day 9 disclosed mild central aortic egurgitation along with a mild pericardial effusion. Another ransthoracic echocardiogram performed on postimplantation ay 15 showed an aggravation of both the aortic regurgitation nd the pericardial effusion. Clinically, the patient was asymptomatic and had no fever or igns of peripheral hypoperfusion. Because the magnitude of he aortic insufficiency could preclude the correct functioning t