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首页> 外文期刊>Artificial Organs >Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation
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Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation

机译：左心室辅助装置植入后右心室收缩功能的残留二尖瓣反流的影响

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Significant mitral regurgitation (MR) is thought to decrease after left ventricular assist device (LVAD) implantation, and therefore repair of mitral valve is not indicated in current practice. However, residual moderate and severe MR leads to pulmonary artery pressure increase, thereby resulting in right ventricular (RV) dysfunction during follow-up. We examined the impact of residual MR on systolic function of the right ventricle by echocardiography after LVAD implantation. This study included 90 patients (mean age: 51.7 +/- 10.9 years, 14.4% female) who underwent LVAD implantation (HeartMate II=21, HeartWare569) in a single center between December 2010 and June 2014. Echocardiograms obtained at 3-6 months and over after implantation were analyzed retrospectively. RV systolic function was graded as normal, mild, moderate, and severely depressed. MR (>= moderate) was observed in 43 and 44% of patients at early and late period, respectively. Systolic function of the RV was severely depressed in 16 and 9% of all patients. Initial analysis (mean duration of support 174.3 +/- 42.5 days) showed a statistically significant correlation between less MR and improved systolic function of RV (P=0.01). Secondary echocardiographic analysis (following a mean duration of support of 435.1 +/- 203 days) was also statistically significant for MR degree and RV systolic dysfunction (P= 0.008). Residual MR after LVAD implantation may cause deterioration of RV systolic function and cause right-sided heart failure symptoms. Repair of severe MR, in selected patients such as those with severe pulmonary hypertension and depressed RV, may be considered to improve the patient's clinical course during pump support.
机译：在左心室辅助装置（LVAD）植入后，认为显着的二尖瓣反流（MR）旨在减少，因此目前的实践中未指出二尖瓣的修复。然而，残留中度和严重的MR导致肺动脉压力增加，从而导致随访期间的右心室（RV）功能障碍。我们在LVAD植入后，通过超声心动图检查了右心室的残余MR对右心室的收缩功能的影响。本研究包括90名患者（平均年龄：51.7 +/- 10.9岁，14.4％的女性）在2010年12月至2014年12月之间接受了单一中心的LVAD植入（HeartMate II = 21，Heartware569）。在3-6个月内获得的超声心动图回顾性地分析植入后。 RV收缩功能较正常，轻度，中等和严重抑郁。在早期和晚期患者的43和44％的患者中观察到先生（> =中度）。所有患者的16％和9％的RV的收缩功能严重抑制。初始分析（平均支持174.3 +/- 42.5天）在较少的MR和RV的改善的收缩功能之间存在统计学上显着的相关性（P = 0.01）。次级超声心动图分析（在435.1 +/- 203天的均衡持续时间之后）对于MR程度和RV收缩功能障碍也有统计学意义（p = 0.008）。 LVAD植入后残留MR可能导致RV收缩功能的恶化，导致右侧心力衰竭症状。在选定的患者中修复严重MR，例如具有严重肺动脉高压和抑郁RV的患者，可以考虑在泵支撑期间改善患者的临床过程。

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