Safety, Mortality, and Hemodynamic Impact of Patients with MitraClip Undergoing Left Ventricular Assist Device Implantation

Journal of Cardiovascular Translational Research - 2021
Henrik Fox1,2, Takayuki Gyoten2, Sebastian V. Rojas1,2, Marcus-André Deutsch2, René Schramm1,2, Volker Rudolph1,3, Jan F. Gummert1,2, Michiel Morshuis2,1
1Heart Failure Department, Herz- Und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bochum, Bad Oeynhausen, Germany
2Clinic for Thoracic and Cardiovascular Surgery, Herz- Und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany
3Clinic for General and Interventional Cardiology/Angiology, Herz- Und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bochum, Bad Oeynhausen, Germany

Tóm tắt

The interactions and hemodynamic impact of transcatheter percutaneous mitral valve repair (TMR) have not yet been investigated in patients undergoing left ventricular assist device (LVAD) implantation, but hemodynamic adverse effects are feared in the combination of TMR and LVAD for altered mitral valve flow. This study investigated the hemodynamic interplay in combination of TMR and LVAD in 119 patients, and propensity score match analysis revealed no difference in both perioperative mortality and 2-year follow-up survival (p = 0.84). Nonetheless, postoperatively mean pulmonary arterial pressure, pulmonary capillary wedge pressure, and cardiac index improved, and multivariable cox regression analysis at 2 years identified preoperative total bilirubin and temporary right ventricular mechanical circulatory support as independent risk factors for all-cause mortality but not TMR. Prior TMR has no impact on mortality or cardiovascular complications in patients with LVAD.

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Journal of Cardiovascular Translational Research

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