Aortic Insufficiency during HeartMate 3 Left Ventricular Assist Device Support: AI in HeartMate 3.

ABSTRACT Background Aortic insufficiency (AI) is associated with morbidity and mortality in patients with continuous-flow left ventricular assist devices (LVADs), whereas its impact on the HeartMate 3 LVAD cohorts remains uninvestigated. We aimed to investigate the clinical impact of AI on patients with HeartMate 3 LVADs. Methods and Results Consecutive 61 patients (median 54 years old and 67% male) implanted with HeartMate 3 LVAD between 2015 and 2019 were enrolled and underwent echocardiography at three months following LVAD implantation. AI severity was quantified by the novel Doppler echocardiographic method obtained at the outflow cannula and the calculated regurgitation fraction ≥30% (moderate or greater) was defined as significant. At 3 months post-implant, 12 (20%) had significant AI. They had a higher incidence of death or heart failure readmissions compared to those without significant AI during a 1-year observational period (70% vs. 24%, p = 0.003) with an adjusted hazard ratio of 2.76 (95% confidence interval 1.03–7.88). Conclusion In patients with HeartMate 3 LVAD support, significant AI remains both prevalent and a clinically significant downstream complication.