LVAD and valvular disorders

This is a summary of the relation between LVAD and Different valvular Disorders:

Mitral insufficiency is not an important issue since after LVAD insertion the left ventricle is completely unloaded and the end-diastolic pressure approaches to zero.

Mitral stenosis should be corrected since it may interfere with LVAD filling.

Tricuspid insufficiency should be treated because LVAD filling and success depend on right ventricular forward flow.

Severe aortic valve insufficiency produces a “vicious-circle circulation” and device output returns again and again to the left ventricle via the incompetent aortic valve.

Severe aortic stenosis should always be corrected before permanent cardiac replacement because these patients often have adequate myocardial reserve, even with very low preoperative ejection fractions and severe congestive heart failure

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