Transcatheter valvular therapies in patients with left ventricular assist devices.
LVAD (left ventricular assist device)
TAVR—transcatheter aortic valve replacement
aortic regurgitation (AR)
mitral regurgitation (MR)
percutaneous valve intervention
transcatheter heart valve interventions
tricuspid regurgitation (TR)
valvular heart disease (VHD)
Journal
Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388
Informations de publication
Date de publication:
2023
2023
Historique:
received:
16
10
2022
accepted:
21
02
2023
medline:
31
3
2023
entrez:
30
3
2023
pubmed:
31
3
2023
Statut:
epublish
Résumé
Aortic, mitral and tricuspid valve regurgitation are commonly encountered in patients with continuous-flow left ventricular assist devices (CF-LVADs). These valvular heart conditions either develop prior to CF-LVAD implantation or are induced by the pump itself. They can all have significant detrimental effects on patients' survival and quality of life. With the improved durability of CF-LVADs and the overall rise in their volume of implants, an increasing number of patients will likely require a valvular heart intervention at some point during CF-LVAD therapy. However, these patients are often considered poor reoperative candidates. In this context, percutaneous approaches have emerged as an attractive "off-label" option for this patient population. Recent data show promising results, with high device success rates and rapid symptomatic improvements. However, the occurrence of distinct complications such as device migration, valve thrombosis or hemolysis remain of concern. In this review, we will present the pathophysiology of valvular heart disease in the setting of CF-LVAD support to help us understand the underlying rationale of these potential complications. We will then outline the current recommendations for the management of valvular heart disease in patients with CF-LVAD and discuss their limitations. Lastly, we will summarize the evidence related to transcatheter heart valve interventions in this patient population.
Identifiants
pubmed: 36993995
doi: 10.3389/fcvm.2023.1071805
pmc: PMC10040555
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
1071805Informations de copyright
© 2023 Dagher, Santaló-Corcoy, Perrin, Dorval, Duggal, Modine, Ducharme, Lamarche, Noly, Asgar and Ben Ali.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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