Effect of concomitant mitral valve procedures for severe mitral regurgitation during left ventricular assist device implantation

Masashi Kawabori*, Chitaru Kurihara, Ryan T. Conyer, Andre C. Critsinelis, Tadahisa Sugiura, Todd Rosengart, Jeffrey A. Morgan

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

The effect of performing a concomitant mitral valve procedure (MVP) during continuous-flow left ventricular assist device (CF-LVAD) implantation has been reported for patients with moderate-to-severe mitral regurgitation (MR), but moderate MR is less of a clinical concern for CF-LVAD patients. There is a paucity of reports focusing on patients with severe MR. Thus, the purpose of this study was to analyze the effect of performing a concomitant MVP during CF-LVAD implantation in patients with severe preoperative MR. Between November 2003 and March 2016, 526 patients underwent primary implantation of a CF-LVAD at our center. Patients with severe MR who underwent a concomitant MVP were compared to those who did not in regard to overall survival, perioperative complications, postoperative echocardiography data, bridge-to-transplantation success, and CF-LVAD explantation. Of the 108 patients with severe MR, 26 underwent a concomitant MVP and 82 did not. These groups showed no difference in survival (p = 0.61). Additionally, the two groups had similar rates of postoperative right heart failure (p = 0.69) and readmissions (p = 0.42). The 24-month follow-up echocardiography results were also similar. Furthermore, the groups showed no difference in bridge-to-cardiac transplantation success (30.0% vs 25.0%, p = 0.80) or CF-LVAD explantation rates (0.0% vs 0.0%. p = 1.0). Our findings suggest that patients with severe MR who undergo a MVP during CF-LVAD implantation do not have superior outcomes to those who do not. However, assessments of other outcomes may show some benefits to performing concomitant MVPs.

Original languageEnglish (US)
Pages (from-to)91-97
Number of pages7
JournalJournal of Artificial Organs
Volume22
Issue number2
DOIs
StatePublished - Jun 14 2019

Keywords

  • Heart failure
  • Left ventricular assist device
  • Mechanical circulatory support
  • Mitral regurgitation

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering
  • Cardiology and Cardiovascular Medicine

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