Mitral valve repair at the time of continuous-flow left ventricular assist device implantation confers meaningful decrement in pulmonary vascular resistance

Sharven Taghavi, Eman Hamad, Lynn Wilson, Rachael Clark, Senthil N. Jayarajan, Nir Uriel, Daniel J. Goldstein, Hiroo Takayama, Yoshifumi Naka, Abeel A. Mangi

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

We hypothesized that the addition of mitral valve replacement or repair (MVR) to implantation of continuous-flow left ventricular assist device (cf-LVAD) may further decrease pulmonary vascular resistance (PVR) over Heartmate II (HMII) implantation alone. Patients undergoing MVR with concomitant HMII implantation were compared with those undergoing HMII implantation alone. Of the 57 patients undergoing cf-LVAD implantation, 21 (36.8%) underwent concomitant MVR and 36 (63.2%) underwent cf-LVAD implantation alone. Patients receiving MVR had greater decrement in PVR (59.4% vs. 35.2%, p = 0.01). Decrease in end-diastolic diameter was greater for patients receiving MVR but did not reach statistical significance (18.2 vs. 13.5 mm, p = 0.33). Duration of mechanical ventilation (121.6 vs. 181.4 hours, p = 0.45) and inotropic support (162.4 vs. 153.2 hours, p = 0.86), change in creatinine (0.19 vs. -0.26 mg/dl, p = 0.34), increase in bilirubin (2.54 vs. 1.55 mg/dl, p = 0.63), intensive care unit stay (168.0 vs. 231.5 hours, p = 0.38), and overall length of stay (32.0 vs. 42.5 days, p = 0.75) were similar. There was no difference in survival at 3 months (89.7% vs. 83.3%) and 1 year (83.7 vs. 67.3%, p = 0.34). Addition of MVR may result in greater decrement of PVR than HMII implantation alone. This may permit certain patients thought to be ineligible for transplantation to become candidates.

Original languageEnglish (US)
Pages (from-to)469-473
Number of pages5
JournalASAIO Journal
Volume59
Issue number5
DOIs
StatePublished - 2013

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Left ventricular assist devices
Heart-Assist Devices
Mitral Valve
Vascular Resistance
Repair
Intensive care units
Bilirubin
Creatinine
Artificial Respiration
Intensive Care Units
Length of Stay
Transplantation
Survival

ASJC Scopus subject areas

  • Biophysics
  • Biomaterials
  • Bioengineering
  • Biomedical Engineering
  • Medicine(all)

Cite this

Mitral valve repair at the time of continuous-flow left ventricular assist device implantation confers meaningful decrement in pulmonary vascular resistance. / Taghavi, Sharven; Hamad, Eman; Wilson, Lynn; Clark, Rachael; Jayarajan, Senthil N.; Uriel, Nir; Goldstein, Daniel J.; Takayama, Hiroo; Naka, Yoshifumi; Mangi, Abeel A.

In: ASAIO Journal, Vol. 59, No. 5, 2013, p. 469-473.

Research output: Contribution to journalArticle

Taghavi, Sharven ; Hamad, Eman ; Wilson, Lynn ; Clark, Rachael ; Jayarajan, Senthil N. ; Uriel, Nir ; Goldstein, Daniel J. ; Takayama, Hiroo ; Naka, Yoshifumi ; Mangi, Abeel A. / Mitral valve repair at the time of continuous-flow left ventricular assist device implantation confers meaningful decrement in pulmonary vascular resistance. In: ASAIO Journal. 2013 ; Vol. 59, No. 5. pp. 469-473.
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abstract = "We hypothesized that the addition of mitral valve replacement or repair (MVR) to implantation of continuous-flow left ventricular assist device (cf-LVAD) may further decrease pulmonary vascular resistance (PVR) over Heartmate II (HMII) implantation alone. Patients undergoing MVR with concomitant HMII implantation were compared with those undergoing HMII implantation alone. Of the 57 patients undergoing cf-LVAD implantation, 21 (36.8{\%}) underwent concomitant MVR and 36 (63.2{\%}) underwent cf-LVAD implantation alone. Patients receiving MVR had greater decrement in PVR (59.4{\%} vs. 35.2{\%}, p = 0.01). Decrease in end-diastolic diameter was greater for patients receiving MVR but did not reach statistical significance (18.2 vs. 13.5 mm, p = 0.33). Duration of mechanical ventilation (121.6 vs. 181.4 hours, p = 0.45) and inotropic support (162.4 vs. 153.2 hours, p = 0.86), change in creatinine (0.19 vs. -0.26 mg/dl, p = 0.34), increase in bilirubin (2.54 vs. 1.55 mg/dl, p = 0.63), intensive care unit stay (168.0 vs. 231.5 hours, p = 0.38), and overall length of stay (32.0 vs. 42.5 days, p = 0.75) were similar. There was no difference in survival at 3 months (89.7{\%} vs. 83.3{\%}) and 1 year (83.7 vs. 67.3{\%}, p = 0.34). Addition of MVR may result in greater decrement of PVR than HMII implantation alone. This may permit certain patients thought to be ineligible for transplantation to become candidates.",
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AU - Goldstein, Daniel J.

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AU - Naka, Yoshifumi

AU - Mangi, Abeel A.

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