XXXX associated with chronic ventricular assist device support.

@entity1 @entity281 @entity296 @entity3585
Favorable long-term @entity1 outcome after insertion of a left ventricular assist device (LVAD) as a bridge to recovery or destination therapy for the treatment of end-stage @entity296 is adversely affected by pathophysiologic changes affecting the heart. Alterations in the native aortic valve apparatus, specifically aortic valve cusp fusion, is an example of such a phenomenon and may especially affect @entity1 in cases of bridge to recovery, a rare but reported event. A retrospective review of the last 33 LVAD placements at our institution was conducted, including reviews of operative reports and pathologic examinations of the native hearts. Seven hearts were found to have varying degrees of aortic valve cusp fusion after chronic LVAD support (63-1, 339 days). Five of these @entity1 had native aortic valves, and two had bioprosthetic valves. The left ventricular outflow tracts in two @entity1 were surgically occluded at the time of LVAD insertion. Aortic valve cusp fusion occurs in roughly 25% of @entity1 on chronic LVAD support. This phenomenon may prove to be clinically significant by creating a potential source of @entity281 . In addition, in the case of @entity296 , left @entity3585 could limit parallel flow and produce suprasystemic ventricular pressures that in turn would elevate left ventricular end diastolic pressures. The latter may contribute to further @entity296 , ultimately limiting the ability of an otherwise recovered heart to be weaned from LVAD support.
