Persistent mitral regurgitation after left ventricular assist device: a clinical conundrum
Author
Cruz Rodriguez, Jose B.Chatterjee, Arka
Pamboukian, Salpy V.
Tallaj, Jose A.
Joly, Joanna
Lenneman, Andrew
Aryal, Sudeep
Hoopes, Charles W.
Acharya, Deepak
Rajapreyar, Indranee
Affiliation
Division of Cardiovascular Diseases, University of ArizonaIssue Date
2021-01-20
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Wiley-BlackwellCitation
Rodriguez, J. C., Chatterjee, A., Pamboukian, S. V., Tallaj, J. A., Joly, J., Lenneman, A., ... & Rajapreyar, I. G. (2020). Persistent Mitral Regurgitation after Left Ventricular Assist Device: A Clinical Conundrum. The Journal of Heart and Lung Transplantation, 39(4), S402.Journal
ESC Heart FailureRights
© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License.Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
Aims: Persistent mitral valve regurgitation (MR) after continuous flow left ventricular assist device implantation (cfLVAD) is associated with pulmonary hypertension and right ventricular failure with variable effects on survival across published studies. The aim of this study is to determine the incidence and predictors of persistent MR at 6-month follow-up after cfLVAD implantation and its impact on survival, haemodynamics, right ventricular function, and morbidity. Methods and results: We performed a retrospective review of all adult cfLVAD recipients from January 2012 to June 2017 at a single tertiary university hospital with follow-up until April 2019. Primary outcome was to compare survival between patients with no-to-mild compared with persistent moderate-to-severe MR at 6 months. Secondary outcomes included right heart failure (RHF), length of stay, re-hospitalizations, and composite of death, transplant, and pump exchange during the length of follow-up. Final analytic sample was 111 patients. The incidence of persistent moderate or severe MR at 6 months was 26%. Significant predictors of persistent MR at 6 months were left atrium dimension and volume. The group with persistent moderate-to-severe MR at 6 months had higher incidence of RHF at 6 months (45% vs. 25%, P = 0.04). There was no difference in survival at 1 year between the groups (no-to-mild MR 85.5%, moderate-to-severe MR 87.9%, Wilcoxon P-value = 0.63). There was no difference in re-hospitalizations, length of stay, composite of death, transplant, or pump exchange during the length of follow-up between the comparison groups. Conclusions: Persistent moderate-to-severe MR after cfLVAD implantation is present in one fourth of patients and is associated with increased incidence of RHF, higher mean pulmonary pressure, and pulmonary capillary wedge pressure with no effect on 1 year survival. Increased left atrium size was associated with persistent moderate-to-severe MR at 6 months.Note
Open access journalISSN
2055-5822EISSN
2055-5822Version
Final published versionae974a485f413a2113503eed53cd6c53
10.1002/ehf2.12919
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Except where otherwise noted, this item's license is described as © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License.