IIZUKA Kei    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Assistant Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Outflow graft anastomosis site design could be correlated to aortic valve regurgitation under left ventricular assist device support.
Journal	Formal name：Journal of Artificial Organs Abbreviation：J Artif Organs ISSN code：1434-7229/1619-0904
Domestic / Foregin	Domestic
Publisher	The Japanese Society for Artificial Organs
Volume, Issue, Page	21(2),pp.150-155
Author and coauthor	IIZUKA Kei†, NISHINAKA Tomohiro, ICHIHARA Yuki, MIYAMOTO Takuma, YAMAZAKI Kenji*
Authorship	Lead author
Publication date	2018/01
Summary	Aortic valve regurgitation (AR) is a critical complication during circulatory support with a left ventricular assist device (LVAD). The time-course of AR and related factors, including outflow graft anastomosis site design, were investigated. Twenty-three patients who had continuous-flow LVAD implantation and were supported for more than 6 months were investigated. AR grade (none, 0; trivial, 0.5; mild, 1; mild-moderate, 1.5; moderate, 2; moderate-severe, 2.5; severe, 3) and aortic valve opening were evaluated with echocardiography. Computed tomography was performed to all the patients postoperatively. The angle of the outflow graft to the aorta (O-A angle, parallel 0; tangent 90°, 0-180°), aortic diameter at the anastomosis site, sino-tubular junction (STJ) diameter, distance between the STJ and the anastomosis site, and distance between the anastomosis site and the brachiocephalic artery were measured. The patients' age was 38 ± 11 years. Support duration was 686 ± 354 days. Mean AR grade after continuous-flow LVAD implantation was increased to around mild and was maintained thereafter. No patient needed any intervention to the aortic valve. The aortic valves of 82.6% of patients were closed continuously. The O-A angle (83 ± 14) was positively correlated with maximum AR grade (p = 0.0095). The O-A angle was significantly smaller in patients with maximum AR grade of 1 or less (77 ± 9°) than in those with 1.5 or greater (94 ± 15°, p = 0.021). The other CT measurements had no correlation with AR grade. In conclusion, the O-A angle was correlated with AR grade progression. The O-A angle appears to be one of the important factors related to AR under continuous-flow LVAD support.
DOI	10.1007/s10047-017-1006-1
PMID	29164425