Letter to the Editor - Impact of Residual Mitral Regurgitation on Right Ventricular Systolic Function After Left Ventricular Assist Device Implantation: Evidence for Populational Differences

摘要

To the Editor, I read with great interest the recent article by Ertugay et al. published in the journal (1). The authors are to be congratulated on gathering their echocardiographic findings after left ventricular assist device (LVAD) implantation with continuous pump in 90 patients. As the authors indicate, LVAD implantation is increasingly used for patients with end-stage heart failure. Significant preoperative mitral regurgitation (MR) is common in these patients, which is expected to decrease after LVAD implantation (2). The article indicates that moderate to severe MR was observed in 43 and 44% of patients at the early and late period after LVAD implantation. These figures appear to be higher than reported previously in the literature (3,4). Kassis et al. (3) recently reported their findings in 69 patients after continuous flow LVAD implantation. Post-LVAD implantation, 55 patients (80%) had mild or less MR and only 20% had significant residual MR. In the study by Kitada et al., which was smaller in size, of 43 patients, 13 (30.2%) continued to have significant MR post-LVAD. As the authors discussed, mitral valve morphology, pump settings, patient and procedure related factors can all contribute to severity of MR in the post LVAD setting. Previously, populational differences have been reported in the predictors and echocardiographic parameters of heart failure in Turkey, which may also potentially contribute to the heterogeneity in the outcome after LVAD implantation (5).