Why the study?
Does MitraClip implantation prior to LVAD affect outcomes in patients with advanced heart failure and severe mitral regurgitation?
Does MitraClip implantation prior to LVAD affect outcomes in patients with advanced heart failure and severe mitral regurgitation?
In patients with advanced heart failure and severe mitral regurgitation, attempting percutaneous mitral valve repair before LVAD may delay definitive therapy and worsen peri-operative right ventricular function.
May caution against MitraClip before LVAD in advanced HF; hypothesis-generating for delayed implantation impairing RV function.
LVAD implantation after MC is feasible and safe. However, in patients with advanced HF and severe MR, PMVR may only delay a needed LVAD implantation and thereby lead to poorer peri-operative RV function and impaired outcome. Arguably, these patients might benefit from the timely management of advanced HF by the means of early LVAD implantation or heart transplantation.
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Kreußer et al. (2020) studied this question.
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