058MITRAL REGURGITATION AND ITS INFLUENCE ON LONG-TERM OUTCOME IN PATIENTS WITH VENTRICULAR ASSIST DEVICES

• Published in: Interactive cardiovascular and thoracic surgery 2013-10, Vol.17 (suppl_2), p.S83-S83
• Main Authors: Bernhardt, A.M., Wagner, F.M., Biermann, D., Klusmeier, M., Muellerleile, K., Blankenberg, S., Deuse, T., Reichenspurner, H.
• Format: Article
• Language: English
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivt372.58

Objectives: Mitral regurgitation of any degree is a common finding in failing hearts and is linked to left ventricular geometry. However, the impact of mitral regurgitation at the time of ventricular assist implantation on long-term outcome is a matter of discussion. The aim of this study is to evaluate changes in left ventricular geometry, and mitral regurgitation during follow-up and its influence on long-term outcome. Methods: Thirty-two consecutive patients, mean age 52.3 ± 7.6 years, underwent continuous flow centrifugal ventricular assist implantation. Mean follow-up was 10.1 ± 6.2 months. Prospectively compiled transthoracic echocardiography data (baseline and follow-up) were retrospectively analysed. Endpoints were death, stroke, thromboembolic events, major bleeding and right heart failure during follow-up. Follow-up was complete in all patients. Results: The ejection fraction improved (16.3 ± 9.0%, P = 0.007) and left ventricular size decreased (left ventricular end diastolic diameter, 56.0 ± 7 to 50.3 ± 11 mm, P = 0.02). Twenty patients (62.5%) had mitral regurgitation of any degree; 10 patients (31.3%) had moderate mitral regurgitation at the time of implantation. After unloading, three patients (9.4%) had moderate (P = 0.04) and 15 patients mild regurgitation (46.9%). One-year survival in patients without regurgitation during follow-up was better than in patients with any degree of regurgitation (92.3% vs 83.3%, P = 0.03). One-year event-free survival was decreased in patients with mitral regurgitation (85.7% vs 72.2%, P = 0.006). Conclusions: Left ventricular diameter improved during ventricular assist support. The degree of mitral regurgitation decreased in a significant portion of patients after assist implantation. Survival and event-free survival was better in patients supported with ventricular assist devices without mitral regurgitation.