De Novo Aortic Regurgitation After Continuous-Flow Left Ventricular Assist Device Implantation Hrvoje Gasparovic, MD, PhD, Tomislav Kopjar, MD, PhD,

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De Novo Aortic Regurgitation After Continuous-Flow Left Ventricular Assist Device Implantation Hrvoje Gasparovic, MD, PhD, Tomislav Kopjar, MD, PhD, Diyar Saeed, MD, PhD, Maja Cikes, MD, PhD, Lucija Svetina, MD, Mate Petricevic, MD, PhD, Daniel Lovric, MD, Davor Milicic, MD, PhD, Bojan Biocina, MD, PhD The Annals of Thoracic Surgery Volume 104, Issue 2, Pages 704-711 (August 2017) DOI: 10.1016/j.athoracsur.2017.01.114 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Study flow diagram depicting the literature search strategy. (AR = aortic regurgitation; AoV = aortic valve; CAVI = concomitant aortic valve intervention; pf-LVAD = pulsatile flow left ventricular assist device; vs. = versus.) The Annals of Thoracic Surgery 2017 104, 704-711DOI: (10.1016/j.athoracsur.2017.01.114) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Impact of age on the development of de novo aortic regurgitation (AR) after continuous flow left ventricular assist device implantation. (B) Impact of male sex on the development of de novo aortic regurgitation after continuous flow left ventricular assist device implantation. (CI = confidence interval; IV = inverse-variance; M-H = Mantel-Haenszel.) The Annals of Thoracic Surgery 2017 104, 704-711DOI: (10.1016/j.athoracsur.2017.01.114) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 (A) Forest plot detailing the impact of continuous closure of the aortic valve on the development of de novo aortic regurgitation (AR) in continuous flow left ventricular assist device recipients. (B) Impact of the duration of continuous flow left ventricular assist device support on the development of de novo aortic regurgitation after continuous flow left ventricular assist device implantation. (CI = confidence interval; IV = inverse-variance; M-H = Mantel-Haenszel.) The Annals of Thoracic Surgery 2017 104, 704-711DOI: (10.1016/j.athoracsur.2017.01.114) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Fig 1 Funnel plots of comparisons between cohorts with and without de novo aortic regurgitation for outcomes: (A) age; (B) male sex; (C) continuous closure of the aortic valve; and (D) duration of support. The Annals of Thoracic Surgery 2017 104, 704-711DOI: (10.1016/j.athoracsur.2017.01.114) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions