Fusion of prosthetic valve during left heart bypass

We recently utilized a left ventricular assist device in a patient who could not be separated from cardiopulmonary bypass after aortic and mitral valve replacement. The nonfunctioning pericardial aortic valve became completely occluded owing to a fibrinous fusion of the valve leaflets during the 8-day period of assist pumping. A second operation was required to open the fused valve leaflets. This experience suggests that special care should be taken in selecting an aortic valve prosthesis in a patient who may require the left ventricular assist device in order to be separated from cardiopulmonary bypass.