Journal of Artificial Organs

, Volume 21, Issue 2, pp 164–171 | Cite as

Impact of mitral valve intervention with left ventricular assist device implantation on postoperative outcomes and morphologic change

  • Hiroki Hata
  • Tomoyuki Fujita
  • Hatsue Ishibashi-Ueda
  • Kensuke Kuroda
  • Osamu Seguchi
  • Yorihiko Matsumoto
  • Masanobu Yanase
  • Takuma Sato
  • Seiko Nakajima
  • Norihide Fukushima
  • Junjiro Kobayashi
Original Article Artificial Heart (Clinical)

Abstract

Although mitral regurgitation (MR) is prevalent in patients with end-stage heart failure, the impact of mitral valve (MV) surgery on outcomes after left ventricular assist device (LVAD) implantation and morphologic changes of MV remains unclear. We retrospectively reviewed 74 patients who underwent LVAD implantation as a bridge to transplant. Of these, 11 (15%) underwent MV repair concomitant with or prior to LVAD implantation, while 27 patients with preoperative significant (moderate or greater) MR did not undergo concomitant MV surgery. The mean interval between LVAD implantation and the last echocardiographic examination was 913 days. Irrespective of MV surgery, significant LV reverse remodeling including decreased LV and left atrial dimension and improved MR severity was observed in all patients except for patients with prior MV surgery. Histopathological examination of explanted hearts removed at heart transplantation (n = 69) or autopsy (n = 5) revealed that the MV annulus was still dilated (mean perimeter 11.7 cm) in the patients with preoperative significant MR and no concomitant MV surgery. Concomitant MV surgery at the time of LVAD implantation for significant MR might not be always necessary for bridge to transplant or destination therapy cases. However, it might be required in patients having potential for cardiac recovery or patients with severe pulmonary hypertension and depressed right ventricle.

Keywords

Left ventricular assist device Mitral regurgitation Mitral valve Reverse remodeling 

Notes

Acknowledgements

This work was supported by the Japan Society for the Promotion of Science (JSPS) Grants-in-Aid for Scientific Research (KAKENHI; Grant Number JP16K10446).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Society for Artificial Organs 2017

Authors and Affiliations

  • Hiroki Hata
    • 1
    • 4
  • Tomoyuki Fujita
    • 1
  • Hatsue Ishibashi-Ueda
    • 2
  • Kensuke Kuroda
    • 3
  • Osamu Seguchi
    • 3
  • Yorihiko Matsumoto
    • 1
  • Masanobu Yanase
    • 3
  • Takuma Sato
    • 3
  • Seiko Nakajima
    • 3
  • Norihide Fukushima
    • 3
  • Junjiro Kobayashi
    • 1
  1. 1.Department of Cardiovascular SurgeryNational Cerebral and Cardiovascular CenterSuitaJapan
  2. 2.Department of PathologyNational Cerebral and Cardiovascular CenterSuitaJapan
  3. 3.Department of TransplantationNational Cerebral and Cardiovascular CenterSuitaJapan
  4. 4.Department of Cardiovascular SurgeryOsaka University Graduate School of MedicineSuitaJapan

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