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Transcatheter valvular therapies in patients with left ventricular assist devices

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 detrime...

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Autores principales: Dagher, Olina, Santaló-Corcoy, Marcel, Perrin, Nils, Dorval, Jean-François, Duggal, Neal, Modine, Thomas, Ducharme, Anique, Lamarche, Yoan, Noly, Pierre-Emmanuel, Asgar, Anita, Ben Ali, Walid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10040555/
https://www.ncbi.nlm.nih.gov/pubmed/36993995
http://dx.doi.org/10.3389/fcvm.2023.1071805
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author Dagher, Olina
Santaló-Corcoy, Marcel
Perrin, Nils
Dorval, Jean-François
Duggal, Neal
Modine, Thomas
Ducharme, Anique
Lamarche, Yoan
Noly, Pierre-Emmanuel
Asgar, Anita
Ben Ali, Walid
author_facet Dagher, Olina
Santaló-Corcoy, Marcel
Perrin, Nils
Dorval, Jean-François
Duggal, Neal
Modine, Thomas
Ducharme, Anique
Lamarche, Yoan
Noly, Pierre-Emmanuel
Asgar, Anita
Ben Ali, Walid
author_sort Dagher, Olina
collection PubMed
description 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.
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spelling pubmed-100405552023-03-28 Transcatheter valvular therapies in patients with left ventricular assist devices Dagher, Olina Santaló-Corcoy, Marcel Perrin, Nils Dorval, Jean-François Duggal, Neal Modine, Thomas Ducharme, Anique Lamarche, Yoan Noly, Pierre-Emmanuel Asgar, Anita Ben Ali, Walid Front Cardiovasc Med Cardiovascular Medicine 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. Frontiers Media S.A. 2023-03-13 /pmc/articles/PMC10040555/ /pubmed/36993995 http://dx.doi.org/10.3389/fcvm.2023.1071805 Text en © 2023 Dagher, Santaló-Corcoy, Perrin, Dorval, Duggal, Modine, Ducharme, Lamarche, Noly, Asgar and Ben Ali. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Dagher, Olina
Santaló-Corcoy, Marcel
Perrin, Nils
Dorval, Jean-François
Duggal, Neal
Modine, Thomas
Ducharme, Anique
Lamarche, Yoan
Noly, Pierre-Emmanuel
Asgar, Anita
Ben Ali, Walid
Transcatheter valvular therapies in patients with left ventricular assist devices
title Transcatheter valvular therapies in patients with left ventricular assist devices
title_full Transcatheter valvular therapies in patients with left ventricular assist devices
title_fullStr Transcatheter valvular therapies in patients with left ventricular assist devices
title_full_unstemmed Transcatheter valvular therapies in patients with left ventricular assist devices
title_short Transcatheter valvular therapies in patients with left ventricular assist devices
title_sort transcatheter valvular therapies in patients with left ventricular assist devices
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10040555/
https://www.ncbi.nlm.nih.gov/pubmed/36993995
http://dx.doi.org/10.3389/fcvm.2023.1071805
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