PURPOSE: To compare the reduction in pulmonary vascular resistance (PVR) after Heartmate XVE and Heartmate II implantation. To study any additional reduction in PVR with the addition of mitral valve repair (MVR) to Heartmate II.
METHODS: Retrospective analysis of patients thought to be ineligible for transplantation due to elevated PVR (>5 Woods Units) undergoing implantation of Heartmate XVE or Heartmate II from 2003 to present day.
RESULTS: In patients undergoing Heartmate XVE implantation, PVR fell from a mean of 3.1 (range: 2.4 to 3.5) to a mean of 1.5 WU (0.8 to 2.7) which translated into a 51.5% reduction (P=0.05). In patients undergoing Heartmate 2 implantation, PVR fell from a mean of 11.3 (range: 10.0 to 12.8) to a mean of 3.3 WU (range: 2.6 to 3.7) which translated into a 70.7% reduction (P=0.01). In patients undergoing Heartmate 2 implantation with concomitant mitral valve repair, PVR fell from a mean of 13.3 (range: 9.0 to 18.7) to a mean of 4.8 WU (range: 1.4 to 8.1) which translated into a 62.6% reduction (P=0.02). The percent reduction in PVR between all three groups did not reach statistical significance. Reduction in PVR was accomplished within a median of 140 days (range: 29 to 217 days).
CONCLUSIONS: Heartmate XVE and Heartmate II appear to be equally effective in reducing pulmonary vascular resistance. The addition of a mitral valve repair does not appear to confer additional advantage to Heartmate II implantation in this regard.
CLINICAL IMPLICATIONS: Heartmate XVE and Heartmate II allow patients previously thought to be ineligible for transplantation to become candidates.
DISCLOSURE: The following authors have nothing to disclose: Sharven Taghavi, Senthil Jayarajan, Lynn Benish, Lynn Wilson, Abeel Mangi
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