Comparing Changes in Aortic and Mitral Valve Function with Axial (AX) Versus Centrifugal (CR) Left Ventricular Assist Devices

LVADs have become an established treatment for end-stage heart failure. One complication with LVAD support is development of aortic insufficiency (AI) and subsequent poor outcomes. Mitral regurgitation (MR) generally decreases with LVAD support as a function of ventricular unloading. Studies have shown CR and AX pumps exhibit different flow patterns and levels of pulsatility. The purpose of this study is to evaluate whether these differences impact the progression of AI and MR between patients implanted with AX and CR devices. We prospectively studied heart failure patients implanted with AX and CR flow LVADs. Echocardiograms were evaluated for AI and MR at pre-implant, 1M, 3M, 6 M, and 12M post implant. 133 patients were included in the study, including 107 AX and 26 CR. The change in the number of patients with normal, mild, and moderate/severe AI and MR are summarized in the table below. The % of patients with mild AI increased for both groups and the % of patients with moderate/severe AI increased for the AX cohort. Both groups saw a decrease in patients with moderate/severe MR. Mean levels of AI increased significantly and MR levels decreased significantly for both groups as shown in the figure below. AI increases significantly for both AX and CR devices within 6 M of support, while MR decreases significantly within 1M. Mean levels of AI or MR do not appear to be significantly different between groups at any time point. Our results indicate that although AX and CR devices exhibit different flow patterns and pulsatility, the progression of AI and MR are similar between the two devices.