Safety and Efficacy of Concomitant Mitral Valvuloplasty and Implantation of Domestic Third-generation Magnetically Levitated Left Ventricular Assist Device
10.3969/j.issn.1000-3614.2024.03.005
- VernacularTitle:国产第三代磁悬浮左心室辅助装置植入同期行二尖瓣成形术的初步评价
- Author:
Zhihua WANG
1
;
Xiaoxia DUAN
;
Zeyuan ZHAO
;
Junlong HU
;
Zhigao CHEN
;
Jianchao LI
;
Baocai WANG
;
Zhaoyun CHENG
Author Information
1. 郑州大学华中阜外医院 心外科,郑州 451464
- Keywords:
heart failure;
mitral regurgitation;
left ventricular assist device;
mitral valvuloplasty
- From:
Chinese Circulation Journal
2024;39(3):242-248
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the safety and efficacy of concomitant mitral valvuloplasty(MVP)and implantation of domestic third-generation magnetically levitated Corheart 6 left ventricular assist device(LVAD). Methods:Clinical data of 13 end-stage heart failure patients who underwent Corheart 6 LVAD implantation and MVP at Central China Fuwai Hospital of Zhengzhou University from October 2021 to March 2023 were retrospectively analyzed.Mortality and complication events during hospitalization and at follow-up were collected,and changes in myocardial injury biomarkers,renal function,hemodynamics,and echocardiographic indices were observed. Results:There were no perioperative deaths and no MVP-related complications in these patients.During a mean follow-up of(14.2±5.6)months,2 patients died due to COVID-19 pneumonia and cardiac arrest respectively,11 cases(84.6%)survived.There were no recurrences of moderate-to-severe mitral regurgitation in the survived patients.Compared with preoperative value,higher cardiac output,lower central venous pressure,pulmonary artery systolic pressure(PASP),and mean pulmonary artery pressure(PAMP)were evidenced at 24 h and 72 h postoperatively,estimated glomerular filtration rate was also reduced at 1 week post operation(all P<0.010).High-sensitive troponin T level was significantly increased at 1 week post operation and then reduced at 1 month post operation,but still not returned to pre-operative level([125.5±281.9]pg/ml at baseline,[1 295.6±654.6]pg/ml at 1 week post operation and[278.0±300.5]pg/ml at 1 month post operation).Echocardiography showed that compared with preoperative period,the left ventricular ejection fraction tended to be higher at 1 and 6 months postoperatively(both P>0.017),whereas left ventricular end-diastolic dimension,PASP,and PAMP were significantly reduced(all P<0.010). Conclusions:Domestic third-generation magnetically levitated Corheart 6 LVAD implantation with concomitant MVP is safe and feasible,there is no recurrence of moderate-to-severe mitral regurgitation,a significant reduction in pulmonary artery pressure,and significant hemodynamic improvement in early to mid-term postoperatively are observed in survived patients.
