Document Detail

Simultaneous aortic valve replacement in left ventricular assist device recipients: single-center experience.
MedLine Citation:
PMID:  22661109     Owner:  NLM     Status:  Publisher    
Introduction: Aortic valve regurgitation or the presence of a mechanical aortic valve prosthesis is a relative contraindication for implantation of left ventricular assist devices (LVAD). However, concomitant aortic valve replacement by a biological prosthesis is one of the options in this situation. We analyzed our recent experience with left ventricular assist device implantation and concomitant aortic valve replacement. Methods: Between January 1, 2008 and January 15, 2012, 318 adult patients (>18 years old) were supported with a long-term implantable LVAD in our institution. In 19, simultaneous aortic valve replacement (6 redo and 13 primary procedures) was performed. Patients were divided into 2 groups according to INTERMACS (IM) level: Group 1 (n = 7) consisted of patients with IM level 1-2 and Group 2 (n = 12) of IM level 3-4 patients. As a control cohort we analyzed all LVAD recipients during the study period (n = 299, study group excluded). The control cohort was similarly divided into two groups according to the IM level: Group 3 (n = 162) consisted of patients with IM level 1-2 and Group 4 (n = 137) of those with IM level 3-5. Perioperative data and outcomes in all groups were retrospectively analyzed and compared (Group 1 compared to Group 3; and Group 2 to Group 4). Results: In study Groups 1 and 2 all patients were male; in Groups 3 and 4, 80% and 88% respectively were male. Median age distribution in Groups was 55, 61, 54, and 57 years respectively. Patients from Group 2 were significantly older than those from Group 4 (p = 0.039). Body mass index was significantly lower in Group 1 than in Group 3 (p = 0.033). Cardio-pulmonary bypass time was significantly longer in Groups 1 and 2 compared with Groups 3 and 4 respectively (p=0.001). Patients from Group 1 had a trend more often to develop right ventricular failure requiring a right ventricular assist device (RVAD) than those in Group 3 (p = 0.09). Intensive care unit stay duration of mechanical ventilation and in-hospital mortality in Group 1 were significantly higher than in Group 3 (p = 0.025, p = 0.005, p = 0.038). Patients from Group 2 had similar outcomes compared to those from Group 4. Conclusions: In stable patients, simultaneous aortic valve replacement and LVAD implantation are not associated with an impaired outcome. In patients with cardiogenic shock an additional aortic valve replacement may impair outcome; therefore alternative techniques should be considered.
Nikolay Dranishnikov; Alexander Stepanenko; Evgenij V Potapov; Michael Dandel; Henryk Siniawski; Alexander Mladenow; Michael Hübler; Onnen Grauhan; Yuguo Weng; Thomas Krabatsch; Roland Hetzer; Marian Kukucka
Related Documents :
24136679 - Usefulness of minimum clinically important difference for assessing patients with subax...
23499159 - Automated continuous distraction osteogenesis may allow faster distraction rates: a pre...
22897809 - Partners' ambivalence towards cardiac arrest and hypothermia treatment: a qualitative s...
24293589 - Clinical results, radiological findings and survival of a proximally hydroxyapatite-coa...
22490269 - Surgical treatment of tricuspid regurgitation after mitral valve surgery: a retrospecti...
24660159 - The effect of intravenous magnesium sulfate on laryngospasm after elective adenotonsill...
15168179 - Wear of ultra-high-molecular-weight polyethylene cup articulating with 22.225 mm zircon...
12461269 - Initial experience in humans with a new retrievable inferior vena cava filter.
25308769 - Simultaneous double clipping delivery guide strategy for treatment of severe coaptation...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-1
Journal Detail:
Title:  The International journal of artificial organs     Volume:  -     ISSN:  1724-6040     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802649     Medline TA:  Int J Artif Organs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  0     Citation Subset:  -    
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin - Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Measurement of individualised quality of life amongst young people with indicated personality disord...
Next Document:  An exploratory study of sleep quality, daytime function, and quality of life in patients with mechan...