Table 2

Management of Pre-Operative Echocardiographic Abnormalities in LVAD Candidates

Aortic insufficiencyRepair, replace, or oversew
Tricuspid regurgitationControversial; consider repair or annuloplasty if moderate to severe
Mitral stenosisValvotomy
Mitral regurgitationUsually none if not organic
Patent foramen ovale or atrial septal defectRepair
Aortic root dilation or atheromaConsider alteration in outflow cannula placement
Intracardiac thrombusConsider surgical thrombectomy
Severe right ventricular dysfunctionConsider short-term RVAD or durable BiVAD

BiVAD = biventricular assist device; LVAD = left ventricular assist device; RVAD = right ventricular assist device.