{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:51:33Z","timestamp":1760244693982,"version":"build-2065373602"},"reference-count":17,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>This study aimed to investigate the outcomes of surgical interventions for symptomatic moderate-to-severe aortic regurgitation (AR), including aortic valve replacement (AVR) and repair (AVP), in 184 patients who underwent continuous flow-left ventricular assist device (Cf-LVAD) implantation as a bridge-to-transplant (BTT) between November 2007 and April 2020. Ten patients (median age, 34 (25\u201341) years; 60% men) underwent surgical interventions (AVR, n = 6; AVP, n = 4) late after cf-LVAD implantation. The median duration after the device implantation was 34 (24\u201344) months. Three patients required additional tricuspid valve repair. Aortic valve suturing resulted in severe recurrent AR 6 months postoperatively, due to leaflet cutting in one patient. Seven patients with AVR survived without regurgitation during the study period, except for one non-survivor complicated by liver failure due to postoperative right heart failure. Therefore, six patients after AVP (n = 4) and AVR (n = 2) underwent successful heart transplantation 7 (4\u201313) months after aortic intervention. Kaplan\u2013Meier analysis showed no significant difference in overall survival through 5 years after cf-LVAD implantation, regardless of the surgical AV intervention chosen (log-rank test, p = 0.86). In conclusion, surgical interventions (AVR or AVP) for patients with an ongoing cf-LVAD are safe, effective, and viable options.<\/jats:p>","DOI":"10.3390\/life13010094","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T02:59:01Z","timestamp":1672282741000},"page":"94","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Interventions for Late Aortic Valve Regurgitation Associated with Continuous Flow-Left Ventricular Assist Device Therapy: Experience Gained and Lessons Learned"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7960-6704","authenticated-orcid":false,"given":"Takayuki","family":"Gyoten","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisuke","family":"Amiya","sequence":"additional","affiliation":[{"name":"Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-8042","authenticated-orcid":false,"given":"Minoru","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"i31","DOI":"10.1093\/ejcts\/ezy444","article-title":"Current perspectives on mechanical circulatory support","volume":"55","author":"Schramm","year":"2019","journal-title":"Eur. 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Heart Lung Transplant."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s11897-013-0172-6","article-title":"Management of aortic insufficiency in the continuous flow left ventricular assist device population","volume":"11","author":"Holtz","year":"2014","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s11897-020-00464-0","article-title":"Continuous-flow left ventricular assist devices and the aortic valve: Interactions, issues, and surgical therapy","volume":"17","author":"Goodwin","year":"2020","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1253\/circj.CJ-21-0880","article-title":"JCS\/JSCVS\/JATS\/JSVS 2021 Guideline on implantable left ventricular assist device for patients with advanced heart failure","volume":"86","author":"Ono","year":"2022","journal-title":"Circ. 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Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1055\/s-0042-1742779","article-title":"The HeartWare ventricular assist device (HVAD): A single institutional 10-year experience","volume":"70","author":"Gyoten","year":"2022","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1093\/ejcts\/ezz098","article-title":"2019 EACTS Expert Consensus on long-term mechanical circulatory support","volume":"56","author":"Potapov","year":"2019","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1002\/ehf2.13188","article-title":"Complications of left ventricular assist devices causing high urgency status on waiting list: Impact on outcome after heart transplantation","volume":"8","author":"Immohr","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.healun.2019.03.001","article-title":"Short-term results with transcatheter aortic valve replacement for treatment of left ventricular assist device patients with symptomatic aortic insufficiency","volume":"38","author":"Yehya","year":"2019","journal-title":"J. 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Surg."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/1\/94\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:54:53Z","timestamp":1760147693000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/1\/94"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,29]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["life13010094"],"URL":"https:\/\/doi.org\/10.3390\/life13010094","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2022,12,29]]}}}