Valve disease impacts survival while awaiting heart transplant

More and more, physicians are using the left ventricular assist device, or LVAD, to sustain patients who are awaiting heart transplants. The surgically implanted mechanical device takes over for weak and diseased hearts, acting as a bridge to transplant surgery.

For the LVAD to work optimally, however, the aortic valve, which releases oxygen-rich blood from the heart into the body, must be free from disease. In a study presented Thursday (April 22, 2004) at the International Society of Heart and Lung Transplantation, Temple University researchers reported that survival to transplant rates decreased significantly (43%) when patients had abnormal or diseased aortic valves before receiving an LVAD.

Lead author Erika Feller, M.D., a cardiology fellow at Temple University School of Medicine and Temple University Hospital, found conversely that the majority of patients (76%) who had normal aortic valves before receiving the LVAD survived to transplant.

“What this study might tell us is that patients need to have abnormal valves surgically repaired during the LVAD insertion, or we need to upgrade their listing on the transplant waiting list,” said Feller.

“Most patients in need of heart transplants have very sick hearts with valves that aren’t working well. While the LVAD can be a great help to these patients, it’s important that we also optimize their chances of survival to transplant by fixing such problems as a diseased aortic valve,” she said.