Mitral Intervention with LVAD: Preparing for Recovery. (March 2019)

• Record Type: Journal Article
• Authors: Maxwell, Cory; Whitener, George
• Is Part Of: Seminars in cardiothoracic and vascular anesthesia. Volume 23:Number 1(2019)
• Page Start: 134
• Page End: 139
• Publication Date: 2019-03
• Subjects: cardiac anesthesia -- cardiac surgery -- chronic heart failure -- ischemic mitral regurgitation -- mitral valve -- transesophageal echocardiography; Cardiovascular system -- Surgery -- Methods -- Periodicals; Chest -- Surgery -- Methods -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Anesthesia -- Periodicals; Anesthetics -- Periodicals; Cardiovascular Surgical Procedures -- methods -- Periodicals; Thoracic Surgical Procedures -- methods -- Periodicals; 617.96
• DOI: 10.1177/1089253218788081
• Languages: English
• ISSNs: 1089-2532

Abstract

Left ventricular assist device (LVAD) insertion is an increasingly common treatment of advanced heart failure. Insertion guidelines suggest regurgitant lesions of the mitral valve should not be addressed. However, recent evidence suggests that mitral regurgitation may not necessarily improve with LVAD insertion, and such patients may have worse outcomes. Thus, practice variability is high given the discrepancy between traditional thinking and new evidence that unrepaired mitral regurgitation may increase perioperative mortality. Additionally, the challenges of LVADs can make transesophageal echocardiography evaluation and assessment of mitral valve pathology difficult.