Mitral Valve Repair at the Time of Continuous-Flow Left Ventricular Assist Device Implantation Confers Meaningful Decrement in Pulmonary Vascular Resistance

被引：52

作者：

Taghavi, Sharven ^{[1
]}

Hamad, Eman ^{[2
,3
]}

Wilson, Lynn ^{[4
]}

Clark, Rachael ^{[1
]}

Jayarajan, Senthil N. ^{[1
]}

Uriel, Nir ^{[5
]}

Goldstein, Daniel J. ^{[6
]}

Takayama, Hiroo ^{[7
]}

Naka, Yoshifumi ^{[7
]}

Mangi, Abeel A. ^{[4
]}

机构：

[1] Temple Univ Hosp & Med Sch, Dept Surg, Philadelphia, PA 19140 USA

[2] Montefiore Albert Einstein Med Ctr, Div Cardiol, Bronx, NY USA

[3] Temple Univ Hosp & Med Sch, Dept Cardiol, Philadelphia, PA 19140 USA

[4] Yale Univ, Sch Med, Sect Cardiac Surg, New Haven, CT 06510 USA

[5] New York Presbyterian Columbia Univ, Med Ctr, Div Cardiol, New York, NY USA

[6] Montefiore Albert Einstein Med Ctr, Dept Cardiothorac & Vasc Surg, Bronx, NY USA

[7] Surg New York Presbyterian Columbia Univ, Med Ctr, Div Cardiac, New York, NY USA

来源：

ASAIO JOURNAL | 2013年 / 59卷 / 05期

关键词：

left ventricular assist device; mechanical circulatory support; heart transplantation; heart failure; HEART-TRANSPLANTATION; CIRCULATORY SUPPORT; HYPERTENSION; BRIDGE; FAILURE; CANDIDATES; SURVIVAL;

D O I：

10.1097/MAT.0b013e31829be026

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

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.

引用

页码：469 / 473

页数：5

共 18 条

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