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Effect of Preoperative Tricuspid and/or Mitral Regurgitation on Development of Late Right-Sided Heart Failure After Insertion of the HeartWare Left Ventricular Assist Device.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2020 Jan 15; Vol. 125 (2), pp. 236-243. Date of Electronic Publication: 2019 Oct 26. - Publication Year :
- 2020
-
Abstract
- Right-sided heart failure (RHF) after left ventricular assist device implantation is a significant cause of morbidity and mortality. Although multiple predictors of early RHF have been described, information on late RHF is scarce. The aim of this study was to identify predictors of late RHF in left ventricular assist device patients. A retrospective analysis of all adult patients who underwent HeartWare-ventricular assist device implantation as a bridge to transplantation in a single-centre was performed. Late RHF was defined as RHF requiring rehospitalization after 30 days of implantation. A total of 16 (10.3%) patients from 156 implantations developed late RHF. Median time to late RHF onset was 182.5 (interquartile range 105 to 618) days. Patients developing late RHF were older at surgery. A significantly higher rate of moderate or severe tricuspid regurgitation before implantation was found in patients presenting with late RHF (81.2% vs 33.5%; p <0.001). Several echocardiographic parameters at discharge postimplant, such as significant mitral regurgitation, demonstrated a strong association with late RHF. A multivariate Cox regression analysis revealed that significant preoperative tricuspid regurgitation was the strongest predictor of late RHF (hazard ratio 5.50, 95% confidence interval [1.34 to 22.58]; p = 0.02). Significant mitral regurgitation postimplantation and older age also significantly predicted late RHF. In conclusion, preoperative significant tricuspid regurgitation and mitral regurgitation after implantation predict the occurrence of late RHF.<br /> (Crown Copyright © 2019. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Disease Progression
Echocardiography
Female
Follow-Up Studies
Heart Failure physiopathology
Heart Failure surgery
Heart Ventricles physiopathology
Humans
Male
Middle Aged
Mitral Valve Insufficiency diagnosis
Mitral Valve Insufficiency physiopathology
Preoperative Period
Prognosis
Retrospective Studies
Severity of Illness Index
Tricuspid Valve Insufficiency diagnosis
Tricuspid Valve Insufficiency physiopathology
Heart Failure etiology
Heart Ventricles diagnostic imaging
Heart-Assist Devices
Mitral Valve Insufficiency complications
Tricuspid Valve Insufficiency complications
Ventricular Function, Right physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 125
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 31767121
- Full Text :
- https://doi.org/10.1016/j.amjcard.2019.10.005