Left Ventricular Assist Device-Related Systolic Aortic Regurgitation

Abstract

A 39-year-old woman underwent transesophageal echocardiography during heart transplantation after 2.5 years of support with a continuous-flow left ventricular assist device (cf-LVAD). The patient was admitted to the hospital when a donor heart became available, and did not present with any symptoms or signs of heart failure on cf-LVAD support. Color-flow imaging demonstrated pronounced systolic aortic regurgitation (AR) while the LVAD was providing full support. The development of this unusual LVAD-related systolic AR may involve dynamic changes in resistance to flow of the aortic valve of an unknown mechanism. In most cases involving a combination of cf-LVAD support and aortic valve incompetence, AR would manifest as a mild-to-moderate diastolic or continuous valve regurgitation.1 Surprisingly, the patient demonstrated pronounced systolic AR (Figure 1 and Movie in the online-only Data Supplement) on support with a …