Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation

Ertugay, Serkan; Kemal, Hatice; Kahraman, Ümit; Engin, Çağatay; Nalbantgil, Sanem; Yağdı, Tahir; Özbaran, Mustafa

doi:10.1111/aor.12831

Cited by 21 publications

(18 citation statements)

References 21 publications

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“…Significant residual MR after CF‐LVAD implantation has important prognostic significance as it has been shown to be deleterious for short and long‐term outcomes and may not allow for sufficient recovery of pulmonary arterial hypertension . Continued significant pulmonary arterial hypertension can preclude patients for heart transplantation .…”

Section: Discussionmentioning

confidence: 99%

Impact of Concomitant Mitral Valve Surgery With LVAD Placement: Systematic Review and Meta‐Analysis

et al. 2018

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The aim of this systematic review and meta-analysis was to evaluate the outcomes of concomitant mitral valve surgery for significant preexisting mitral regurgitation (MR) in patients undergoing continuous-flow left ventricular assist device (CF-LVAD) implantation. Electronic search was performed to identify all studies in the English literature examining concurrent mitral valve surgery in patients with CF-LVAD implantation. Identified articles were systematically assessed for inclusion and exclusion criteria. Of 2319 studies identified, 8 studies were included. Among 445 patients with moderate to severe or severe MR, 113 (25.4%) patients received concurrent mitral valvular intervention during CF-LVAD implantation. There were no significant differences in cardiopulmonary bypass time (MR Surgery 154 min vs. no MR Surgery 119 min, P = 0.64) or hospital length of stay (MR Surgery 21 days vs. no MR Surgery 18 days, P = 0.93). On follow-up, there were no significant differences in freedom from greater than moderate MR (MR Surgery 100% vs. no MR Surgery 74%, P = 0.12) or left ventricular end-diastolic diameter (MR Surgery: 60 mm vs. no MR Surgery 65 mm, P = 0.51). Survival was comparable at 6-months (MR Surgery 77% vs. no MR Surgery 81%, P = 0.75), 1-year (MR Surgery 72% vs. no MR Surgery 80%, P = 0.36), and 2-years of follow-up (MR Surgery 65% vs. no MR Surgery 70%, P = 0.56). The results of our systematic review and meta-analysis of 8 studies consisting of 445 patients demonstrates that the addition of mitral valve intervention to CF-LVAD implantation appears to be safe with comparable survival to those undergoing CF-LVAD implantation alone. Large prospective randomized clinical trials are needed to elucidate whether concomitant mitral valve intervention during CF-LVAD implantation in patients with severe MR is necessary.

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Section: Discussionmentioning

confidence: 99%

Impact of Concomitant Mitral Valve Surgery With LVAD Placement: Systematic Review and Meta‐Analysis

et al. 2018

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“…To the Editor, I read with great interest the recent article by Ertugay et al published in the journal (1). The authors are to be congratulated on gathering their echocardiographic findings after left ventricular assist device (LVAD) implantation with continuous pump in 90 patients.…”

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confidence: 99%

Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation: Evidence for Populational Differences

Ağırbaşlı

2018

Artificial Organs

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To the Editor, I read with great interest the recent article by Ertugay et al. published in the journal (1). The authors are to be congratulated on gathering their echocardiographic findings after left ventricular assist device (LVAD) implantation with continuous pump in 90 patients. As the authors indicate, LVAD implantation is increasingly used for patients with end-stage heart failure. Significant preoperative mitral regurgitation (MR) is common in these patients, which is expected to decrease after LVAD implantation (2). The article indicates that moderate to severe MR was observed in 43 and 44% of patients at the early and late period after LVAD implantation. These figures appear to be higher than reported previously in the literature (3,4). Kassis et al. (3) recently reported their findings in 69 patients after continuous flow LVAD implantation. Post-LVAD implantation, 55 patients (80%) had mild or less MR and only 20% had significant residual MR. In the study by Kitada et al., which was smaller in size, of 43 patients, 13 (30.2%) continued to have significant MR post-LVAD. As the authors discussed, mitral valve morphology, pump settings, patient and procedure related factors can all contribute to severity of MR in the post LVAD setting. Previously, populational differences have been reported in the predictors and echocardiographic parameters of heart failure in Turkey, which may also potentially contribute to the heterogeneity in the outcome after LVAD implantation (5).

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“…Ertugay et al of the Ege University Faculty of Medicine, İzmir, Turkey evaluated the impact of residual mitral regurgitation (MR) on systolic function of the RV by echocardiography after LVAD implantation. This study included 90 patients who underwent LVAD implantation (HeartMate II = 21, HeartWare = 69) in a single center.…”

Section: Cardiac Support and Blood Pumpsmentioning

confidence: 99%

Artificial Organs 2017: A Year in Review

Malchesky¹

2018

Artificial Organs

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In this Editor's Review, articles published in 2017 are organized by category and summarized. We provide a brief reflection of the research and progress in artificial organs intended to advance and better human life while providing insight for continued application of these technologies and methods. Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level." Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ Replacement, Recovery, and Regeneration from all over the world. Peer-reviewed Special Issues this year included contributions from the 12th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion edited by Dr. Akif Undar, Artificial Oxygen Carriers edited by Drs. Akira Kawaguchi and Jan Simoni, the 24th Congress of the International Society for Mechanical Circulatory Support edited by Dr. Toru Masuzawa, Challenges in the Field of Biomedical Devices: A Multidisciplinary Perspective edited by Dr. Vincenzo Piemonte and colleagues and Functional Electrical Stimulation edited by Dr. Winfried Mayr and colleagues. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers the quality expected from such a journal could not be possible. We also express our special thanks to our Publisher, John Wiley & Sons for their expert attention and support in the production and marketing of Artificial Organs. We look forward to reporting further advances in the coming years.

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Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation

Cited by 21 publications

References 21 publications

Impact of Concomitant Mitral Valve Surgery With LVAD Placement: Systematic Review and Meta‐Analysis

Impact of Concomitant Mitral Valve Surgery With LVAD Placement: Systematic Review and Meta‐Analysis

Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation: Evidence for Populational Differences

Artificial Organs 2017: A Year in Review

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