{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T16:11:38Z","timestamp":1789056698669,"version":"build-2803163510"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:00:00Z","timestamp":1783123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004823","name":"Nagoya University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004823","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Artif Organs"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Impella is increasingly used as a bridge to durable left ventricular assist device (dLVAD) implantation in patients with advanced heart failure. However, Impella support may worsen aortic insufficiency (AI), raising concerns regarding both AI progression during support and subsequent late AI progression after dLVAD implantation. This study evaluated the impact of Impella bridging on AI progression and clinical outcomes after dLVAD implantation. This retrospective single-center study included 64 patients who underwent primary dLVAD implantation and consisted of three analyses. First, baseline characteristics, perioperative variables, and early postoperative outcomes were compared between the aortic valve (AV) Intervention (n\u2009=\u200912) and No AV Intervention (n\u2009=\u200952) groups at dLVAD implantation. Second, changes in AI severity during Impella support were evaluated in patients with preoperative Impella support (n\u2009=\u200919). Third, long-term outcomes were compared between the Impella Bridging (n\u2009=\u200914) and No Impella Bridging (n\u2009=\u200938) groups after excluding patients who underwent concomitant AV intervention. Preoperative clinical severity was generally comparable between the AV Intervention and No AV Intervention groups, although hospital mortality was higher in the AV Intervention group. AI severity worsened significantly during Impella support (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), whereas AV intervention rates did not differ significantly according to preoperative Impella support status (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.32). During long-term follow-up, no statistically significant association was observed between Impella bridging and subsequent AI progression or clinical outcomes. Impella support as a bridge to dLVAD implantation was associated with significant worsening of AI during support. Under the current treatment strategy, including careful assessment of AV function and selective concomitant AV intervention at dLVAD implantation, no statistically significant association was observed between prior Impella bridging and subsequent late AI progression or adverse clinical outcomes. However, given the significantly higher in-hospital mortality in the AV Intervention group, careful patient selection for concomitant AV intervention remains essential.\n                  <\/jats:p>","DOI":"10.1007\/s10047-026-01570-x","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T14:52:27Z","timestamp":1783176747000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of aortic insufficiency during Impella support as a bridge to durable left ventricular assist device implantation and its long-term progression"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3854-5108","authenticated-orcid":false,"given":"Tomo","family":"Yoshizumi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomonari","family":"Uemura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasunari","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Kazama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Mutsuga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"1570_CR1","doi-asserted-by":"publisher","first-page":"1233","DOI":"10.1001\/jama.2022.16197","volume":"328","author":"MR Mehra","year":"2022","unstructured":"Mehra MR, Goldstein DJ, Cleveland JC, Cowger JA, Hall S, Salerno CT, et al. Five-year outcomes in patients with fully magnetically levitated vs axial-flow left ventricular assist devices in the MOMENTUM 3 randomized trial. JAMA. 2022;328:1233\u201342.","journal-title":"JAMA"},{"key":"1570_CR2","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1016\/j.jchf.2018.07.012","volume":"6","author":"LK Truby","year":"2018","unstructured":"Truby LK, Garan AR, Givens RC, Wayda B, Takeda K, Yuzefpolskaya M, et al. Aortic insufficiency during contemporary left ventricular assist device support: an analysis of the INTERMACS registry. JACC Heart Fail. 2018;6:951\u201360.","journal-title":"JACC Heart Fail"},{"key":"1570_CR3","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1002\/ejhf.2746","volume":"25","author":"N Uriel","year":"2023","unstructured":"Uriel N, Milano C, Agarwal R, Lee S, Cleveland J, Goldstein D, et al. Incidence and clinical correlates of de novo aortic regurgitation with a fully magnetically levitated left ventricular assist device: a MOMENTUM 3 trial portfolio analysis. Eur J Heart Fail. 2023;25:286\u201394.","journal-title":"Eur J Heart Fail"},{"key":"1570_CR4","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1111\/aor.13906","volume":"45","author":"T Gyoten","year":"2021","unstructured":"Gyoten T, Morshuis M, Fox H, Deutsch MA, Hakim-Meibodi K, Schramm R, et al. Secondary aortic valve replacement in continuous flow left ventricular assist device therapy. Artif Organs. 2021;45:736\u201341.","journal-title":"Artif Organs"},{"key":"1570_CR5","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.healun.2022.12.004","volume":"42","author":"D Saeed","year":"2023","unstructured":"Saeed D, Feldman D, El Banayosy A, Birks E, Blume E, Cowger J, et al. 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