+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Impact of concomitant mitral valve repair for severe mitral regurgitation at the time of continuous-flow left ventricular assist device insertion



Impact of concomitant mitral valve repair for severe mitral regurgitation at the time of continuous-flow left ventricular assist device insertion



Interactive Cardiovascular and Thoracic Surgery 25(4): 620-623



Mitral regurgitation (MR) is common in patients with end-stage heart failure. We assessed the effect of performing concomitant mitral valve repair during continuous-flow left ventricular assist device (CF-LVAD) implantation in patients with severe preoperative MR. We performed a single-centre, retrospective review of all patients who underwent CF-LVAD implantation between December 1999 and December 2013 (n = 469). Patients with severe preoperative MR (n = 78) were identified and then stratified according to whether they underwent concomitant valve repair. Univariate and survival analyses were performed, and multivariable regression was used to determine predictors of survival. Of the 78 patients with severe MR, 21 underwent valve repair at the time of CF-LVAD implantation (repair group) and 57 did not (non-repair group). A comparison of the 2 groups showed significant differences between groups: INTERMACS I 16.985 vs 9.52%, (P = 0.039), cardiopulmonary bypass time 82.09 vs 109.4 min (P = 0.0042) and the use of HeartMate II 63.16 vs 100% (P = 0.001). Survival analysis suggested trends towards improved survival and a lower incidence of heart failure-related readmissions in the repair group. Multivariable regression analysis showed no significant independent predictors of survival (mitral valve repair: odds ratio 0.4, 95% confidence interval 0.8-1.5; P = 0.2). Despite the lack of statistical significance, trends towards improved survival and a lower incidence of heart failure events suggest that mitral valve repair may be beneficial in patients undergoing CF-LVAD implantation. Given the known relationship between severe MR and mortality, further study is encouraged to confirm the value of mitral valve repair in these patients.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 059835882

Download citation: RISBibTeXText

PMID: 28962504

DOI: 10.1093/icvts/ivx223


Related references

The Effect of Concomitant Mitral Valve Procedures for Severe Mitral Valve Regurgitation During Left Ventricular Assist Device Implantation. The Journal of Heart and Lung Transplantation 37(4): S74-S75, 2018

Effect of concomitant mitral valve procedures for severe mitral regurgitation during left ventricular assist device implantation. Journal of Artificial Organs 22(2): 91-97, 2019

Mitral valve repair for severe mitral valve regurgitation during left ventricular assist device implantation. The Journal of Thoracic and Cardiovascular Surgery 157(5): 1841-1848.e1, 2019

What Is the Optimal Setting for a Continuous-Flow Left Ventricular Assist Device in Severe Mitral Regurgitation?. Artificial Organs 40(11): 1039-1045, 2016

Mitral valve repair at the time of continuous-flow left ventricular assist device implantation confers meaningful decrement in pulmonary vascular resistance. Asaio Journal 59(5): 469-473, 2013

Uncorrected pre-operative mitral valve regurgitation is not associated with adverse outcomes after continuous-flow left ventricular assist device implantation. Journal of Heart and Lung Transplantation 34(5): 718-723, 2015

The Impact of Concomitant Mitral Repair in Patients Receiving Continuous-Flow Left Ventricular Assist Devices. Journal of Heart and Lung Transplantation 34(4): S166-S167, 2015

Transapical approach for mitral valve repair during insertion of a left ventricular assist device. Thescientificworldjournal 2013: 925310-925310, 2013

Concomitant mitral valve repair and left ventricular reconstruction in a patient with chronic ischemic mitral regurgitation and inferior left ventricular aneurysm. Japanese Journal of Thoracic and Cardiovascular Surgery 52(2): 71-74, 2004

Time course of left atrial reverse remodelling after mitral valve surgery and the impact of left ventricular global longitudinal strain in patients with chronic severe mitral regurgitation. Interactive Cardiovascular and Thoracic Surgery 23(6): 876-882, 2016

Aortic regurgitation during systolic-phase accompanied by mitral regurgitation in patients with continuous-flow left ventricular assist device. European Heart Journal Cardiovascular Imaging 14(10): 1022, 2013

The Hemodynamic Effects of Concomitant Mitral Valve Repair and Left Ventricular Assist Device Implantation. Journal of Heart and Lung Transplantation 36(4): S102-S103, 2017

Left ventricular reverse remodeling with a continuous flow left ventricular assist device measured by left ventricular end-diastolic dimensions and severity of mitral regurgitation. Asaio Journal 58(6): 574-577, 2012

Concomitant mitral repair and continuous-flow left ventricular assist devices: Is it warranted?. Journal of Thoracic and Cardiovascular Surgery 154(4): 1303-1312.E4, 2017

Significance of Residual Mitral Regurgitation After Continuous Flow Left Ventricular Assist Device Implantation. Jacc. Heart Failure 5(2): 81-88, 2017