Citation

Zhigalov K, Szczechowicz M, Mashhour A, Kadyraliev BK, Mkalaluh S, Easo J, Ennker J, Eichstaedt HC, Weymann A. J. Thorac. Dis. 2019; 11: S902-S912.

Copyright

(Copyright © 2019, Pioneer Bioscience)

DOI

10.21037/jtd.2018.11.116

PMID

unavailable

Abstract

BACKGROUND: The objectives of this study was to investigate if concomitant tricuspid valve repair in patients undergoing continuous flow left ventricular assist device (LVAD) implantation has an impact on the outcome regarding survival and adverse events.

METHODS: Between June 2007 and February 2018, 124 consecutive patients received HeartMate II (HMII) [74 (59.7%)] HeartWare (HVAD) [16 (12.9%)], or HeartMate III (HM III) [34 (27.4%)] for end-stage heart failure. Mean age was 63.5±10.9 years. Two 18-patient groups were identified; with [tricuspid valve reconstruction (TVR)] group and without (non-TVR group) accompanying TVR. The primary endpoint was overall survival after device implantation. Secondary endpoints were adverse events during the follow-up period.

RESULTS: Survival was not significantly different between the groups (P>0.05). In TVR group, there was a higher need for open chest after surgery and a prolonged inotrope use because of right heart failure (RHF), a higher incidence of acute kidney dysfunction requiring dialysis, as well as a higher need for packed red blood cells due to postoperative bleeding (P<0.05).

CONCLUSIONS: In this cohort of patients, LVAD implantation with a concurrent tricuspid valve repair appears to have a worse outcome regarding RHF, bleeding tendency and renal dysfunction (P<0.05). However, the survival was comparable in both TVR and Non-TVR groups (P>0.05). © Journal of Thoracic Disease. All rights reserved.

Language: en

Keywords

adult; human; suicide; female; male; multiple organ failure; survival rate; cause of death; retrospective study; smoking; clinical article; length of stay; middle aged; intensive care unit; sepsis; follow up; acute kidney failure; artificial ventilation; brain hemorrhage; cardiopulmonary arrest; respiratory failure; liver dysfunction; postoperative infection; transient ischemic attack; inotropic agent; brain ischemia; renal replacement therapy; Article; kidney dysfunction; bilirubin; overall survival; implantation; cardiopulmonary bypass; erythrocyte transfusion; congestive cardiomyopathy; postoperative hemorrhage; erythrocyte concentrate; clinical outcome; ischemic cardiomyopathy; atrial fibrillation; tricuspid valve regurgitation; heart right ventricle failure; cardioplegia; heart atrium appendage; Left ventricular assist device (LVAD); Mechanical circulatory support (MCS); open heart surgery; postcardiotomy syndrome; Right heart failure (RHF); tricuspid annuloplasty; Tricuspid regurgitation; tricuspid valve repair; Tricuspid valve repair