https://doi.org/10.1177/0391398820963284 The International Journal of Artificial Organs 1–7 © The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/0391398820963284 journals.sagepub.com/home/jao IJAO Te International Journal of Artifcial Organs Introduction Left ventricular assist device (LVAD) implantation has become an important treatment option due to donor limita- tion. The new generation LVADs diminish pulsatility by changing blood flow dynamics and provide a continuous non-physiological circulation. In patients with continuous- flow LVADs (CF-LVAD), pulsatility could be demonstrated in the pump waveform analysis, if aortic valve opening (AVO) is achieved with left ventricle contraction. 1 More continuous flow, better learning? The effect of aortic valve opening in patients with left ventricular assist device Mehmet Karahan 1 , Sinan Sabit Kocabeyoglu 1 , Umit Kervan 1 , Dogan Emre Sert 1 , Emel Erdogan Bakar 2 , Emre Aygun 1 , Muharrem Tola 3 , Burcu Demirkan 4 , Semra Mungan 5 , Zeki Catav 1 and Mustafa Pac 1 Abstract Purpose: The aim of this study was to analyze neurocognitive function in patients who underwent continuous flow left ventricular assist device (LVAD) implantation. Material and Method: This cross-sectional study included three groups: LVAD (n = 31), heart failure patients (n = 26), and healthy volunteers (n = 27). The Rey Auditory-Verbal Learning Test (RAVLT), Judgement of Line Orientation Test (JLOT), Trail Making Test (TMT), Stroop Color-Word Interference Test (SCWIT), Verbal Fluency Test (VFT), Symbol- Digit Modality Test (SDMT) were used to assess the neurocognitive functions. Data were analyzed at a median 12 (3–47) months after LVAD implantation. The LVAD patients were also divided by aortic valve opening (AVO) into three subgroups as “closed” (n = 9), “1–6” (n = 8) and “7–10” (n = 14) opening per ten beats and data were re-analyzed accordingly. Results: There was no significant difference among the groups according to SCWIT, JLOT, SDMT, TMT, and VFT scores. Post-hoc analyzes of RAVLT scores showed significant differences between the LVAD and the other two groups in favor of the LVAD group. Also, the patients with AVO “7–10” the response times were longer and learning scores were found to be lower than those without AVO. Conclusion: With continuous-flow LVAD, neurocognitive functions were not impaired. The learning performance was better in cases where there was no AVO and flow was completely device dependent. We may speculate that neurocognitive functions are not worsening with continuous cerebral blood flow and even it may improve learning performance. Keywords Left ventricular assist device, neurocognitive functions, aortic valve opening Date received: 9 May 2020; accepted: 10 September 2020 1 Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey 2 Department of Psychology, Ufuk University, Ankara, Turkey 3 Department of Radiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey 4 Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey 5 Department of Neurology, Ankara Numune Hospital, Ankara, Turkey Corresponding author: Mehmet Karahan, Ankara City Hospital, Ankara 06800, Turkey. Email: mehmet.karahan.md@gmail.com 963284JAO 0 0 10.1177/0391398820963284The International Journal of Artificial OrgansKarahan et al. research-article 2020 Original research article