Department of Surgery, Division of Cardiac, Thoracic & Vascular Surgery, Columbia University Irving Medical Center, New York, New York.
Department of Surgery, Center for Innovation and Outcomes Research, Columbia University Irving Medical Center, New York, New York.
Ann Thorac Surg. 2022 Aug;114(2):450-456. doi: 10.1016/j.athoracsur.2021.08.074. Epub 2021 Oct 6.
De novo aortic insufficiency (AI) is a common adverse event after continuous-flow left ventricular assist device (LVAD) placement and is associated with morbidity and mortality. This study aims to compare the development of de novo AI between HeartMate 3 (Abbott) and HeartMate II LVAD recipients.
A retrospective review was conducted of clinical characteristics and serial echocardiograms (1 month, 6 months, and 1 year postimplantation) of HeartMate 3 patients implanted between November 2014 and March 2019 and of HeartMate II patients implanted between April 2004 and December 2015 at Columbia University Irving Medical Center. One hundred twenty-two patients were excluded from analysis for a history of aortic valve surgery, concomitant aortic valve surgery with LVAD implant, or more than trace preoperative AI left untreated. De novo AI was defined as development of more than mild AI after LVAD implant.
Included in the study were 121 HeartMate 3 patients and 270 HeartMate II patients. After accounting for competing risks of death and transplantation, there was no significant difference in the development of de novo AI by 1 year postimplantation between HeartMate II and HeartMate 3 patients (P = .68). There was no significant difference in severity of AI developed up to 1 year post-implantation between HeartMate II and HeartMate 3 patients.
Development of de novo AI is comparable between HeartMate 3 and HeartMate II patients. There is no significant difference in severity of AI between HeartMate II and HeartMate 3 patients.
经皮左心室辅助装置（LVAD）植入后新发主动脉瓣关闭不全（AI）是一种常见的不良事件，与发病率和死亡率相关。本研究旨在比较 HeartMate 3（雅培）和 HeartMate II LVAD 植入患者新发 AI 的发生情况。
对 2014 年 11 月至 2019 年 3 月在哥伦比亚大学欧文医学中心植入 HeartMate 3 的患者的临床特征和连续超声心动图（植入后 1 个月、6 个月和 1 年）以及 2004 年 4 月至 2015 年 12 月植入 HeartMate II 的患者的临床特征进行回顾性分析。排除 122 例患者，排除标准为主动脉瓣手术史、LVAD 植入时合并主动脉瓣手术或未经治疗的术前 AI 超过 trace。新发 AI 定义为 LVAD 植入后出现中度以上 AI。
本研究共纳入 121 例 HeartMate 3 患者和 270 例 HeartMate II 患者。在考虑死亡和移植的竞争风险后，HeartMate II 组和 HeartMate 3 组患者在植入后 1 年时新发 AI 的发生率无显著差异（P=0.68）。在植入后 1 年时，HeartMate II 组和 HeartMate 3 组患者 AI 严重程度的发展无显著差异。
HeartMate 3 组和 HeartMate II 组患者新发 AI 的发生率相当。HeartMate II 组和 HeartMate 3 组患者 AI 严重程度无显著差异。
