Abstract
Patients with mechanical aortic valves are generally contraindicated for left ventricular assist device (LVAD) insertion because the prosthetic valve often becomes fixed in closed position. A 41-year-old woman with mechanical aortic valve prosthesis experienced sudden chest pain and developed cardiogenic shock. A paracorporeal pulsatile LVAD and a monopivot centrifugal pump as a right VAD (RVAD) were implanted. The mechanical aortic valve was intentionally left in place. Soon after the operation, LVAD support was discontinued daily for few seconds to allow the mechanical aortic valve to open and to avoid thrombus formation. The patient was successfully weaned off RVAD and received anticoagulation therapy with warfarin. On postoperative day 141, she was transferred to a university hospital where a HeartMate II LVAD was implanted, and the aortic valve was successfully replaced with a bioprosthetic valve. The patient is currently awaiting heart transplantation.
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Ammirati E, Oliva F, Cannata A, Contri R, Colombo T, Martinelli L, Frigerio M. Current indications for heart transplantation and left ventricular assist device: a practical point of view. Eur J Intern Med. 2014;25:422–9.
Takano H, Taenaka Y, Matsuda T, Umezu M, Nakamura T, Hayashi K, Akutsu T, Manabe H. Development of the clinical ventricular assist system: modification of the blood pump and its evaluation. Jpn J Artif Organs. 1983;12:390–4.
Fukushima N, Ono M, Saiki Y, Sawa Y, Nunoda S, Isobe M. Registry report on heart transplantation in Japan (June 2016). Circ J. 2017. doi:10.1253/circj.CJ-160976.
Adamson RM, Dembitsky WP, Baradarian S, Chammas J, May-Newman K, Chillcott S, Stahovich M, McCalmont V, Ortiz K, Hoagland P, Jaski B. Aortic valve closure associated with heartmate left ventricular device support: technical considerations and long-term results. J Heart Lung Transplant. 2011;30:576–82.
Feldman D, Pamboukian SV, Teuteberg JJ, Birks E, Lietz K, Moore SA, Morgan JA, Arabia F, Bauman ME, Buchholz HW, Deng M. The 2013 International Society for Heart and Lung Transplantation Guidelines for mechanical circulatory support. J Heart Lung Transplant. 2013;32:157–87.
Kazui T, Sydow N, Friedman M, Kim S, Lick S, Khalpey Z. A modified Park’s stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report. J Cardiothorac Surg. 2016;11:161–5.
Rao V, Slater JP, Edwards NM, Naka Y, Oz MC. Surgical management of valvular disease in patients requiring left ventricular assist device support. Ann Thorac Surg. 2001;71:1448–53.
Crestanello JA, Orsinelli DA, Firstenberg MS, Sai-Sudhakar C. Aortic valve thrombosis after implantation of temporary left ventricular assist device. Interact Cardiovasc Thorac Surg. 2009;8:661–2.
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Inoue, T., Kitamura, T., Torii, S. et al. Daily transient discontinuation of extracorporeal LVAD to prevent thromboembolism of mechanical aortic valve prosthesis. J Artif Organs 20, 274–276 (2017). https://doi.org/10.1007/s10047-017-0963-8
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DOI: https://doi.org/10.1007/s10047-017-0963-8