Under LVAD support, de novo aortic insufficiency can develop. The incidence varies in different publications from 10% [454] to 53% [384]. Recirculating blood will lead to systemic hypoperfusion of the patient. Additionally, incomplete unloading of the LV may lead to pulmonary artery hypertension compromising the RV function. Factors contributing to AR are fusion of the commissures and degenerative changes of the cusps caused by persistent aortic valve closure [455]. The diagnosis and the grade of regurgitation can be confirmed by echocardiography.