{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:39:16Z","timestamp":1789731556520,"version":"4.0.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100022438","name":"EACTS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022438","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Mitral regurgitation (MR) is frequently observed in patients undergoing left ventricular assist device implantation. We investigated the impact of preoperative MR on left ventricular assist device patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>A retrospective propensity score-matched analysis of adult patients enrolled in the EUROMACS registry between 1 January 2011 and 30 November 2021 was performed. Patients were divided into 2 groups according to the grade of preoperative MR: none-to-mild (MR 0\u2013II) or moderate-to-severe (MR III\u2013IV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Following 1:1 propensity score matching, each group consisted of 914 patients. Incidence of postoperative temporary right ventricular support, reoperation for bleeding and dialysis was similar. MR III\u2013IV demonstrated shorter median intensive care unit stay [14 days (6; 27.8) vs 10 days (5; 22), P\u2009=\u20090.004] and ventilation time [72\u2009h (22, 320) vs 31\u2009h (18, 150), P\u2009&amp;lt;\u20090.001]. Mortality was lower for MR III\u2013IV patients [subdistribution hazard ratio: 0.66, 95% confidence interval (CI): 0.59\u20130.73, P\u2009&amp;lt;\u20090.001]. The 1-year survival was 68.1% (95% CI: 65.1\u201371.3%) in MR 0\u2013II and 75% (95% CI: 72.1\u201378%) in MR III\u2013IV. A lower incidence of total complications [odds ratio (OR): 0.93 (0.89\u20130.98), P\u2009=\u20090.003] and trend towards a lower risk of neurological dysfunction (subdistribution hazard ratio: 0.79; 95% CI: 0.61\u20131.01, P\u2009=\u20090.063) and sustained ventricular tachycardia [OR: 0.93 (0.54\u20131.03), P\u2009=\u20090.074] were demonstrated for MR III\u2013IV. The risk of fatal stroke and pump thrombosis was similar.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Moderate-to-severe MR in patients undergoing left ventricular assist device implantation is associated with better mid-term survival and lower incidence of total major adverse events and complications. The incidence of severe postoperative complications including fatal stroke and device thrombosis was similar.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad013","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T21:34:15Z","timestamp":1673472855000},"source":"Crossref","is-referenced-by-count":7,"title":["Impact of preoperative mitral regurgitation on left ventricular assist device patients: propensity score-matched analysis of the EUROMACS dataset"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3689-0477","authenticated-orcid":false,"given":"Antonio","family":"Loforte","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9524-7705","authenticated-orcid":false,"given":"Gaik","family":"Nersesian","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9831-6289","authenticated-orcid":false,"given":"Daniel","family":"Lewin","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Lanmueller","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0111-7123","authenticated-orcid":false,"given":"Gregorio","family":"Gliozzi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9132-8073","authenticated-orcid":false,"given":"Julia","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4304-8739","authenticated-orcid":false,"given":"Giulio Giovanni","family":"Cavalli","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-1295","authenticated-orcid":false,"given":"Felix","family":"Schoenrath","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin, Germany"},{"name":"Department of Cardiovascular Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1567-7036","authenticated-orcid":false,"given":"Ivan","family":"Netuka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Institute for Clinical and Experimental Medicine , Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2185-4895","authenticated-orcid":false,"given":"Daniel","family":"Zimpfer","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Medical University of Vienna , Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8991-3348","authenticated-orcid":false,"given":"Theo M M H","family":"de By","sequence":"additional","affiliation":[{"name":"EUROMACS Registry, EACTS , Windsor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6956-9110","authenticated-orcid":false,"given":"Jan","family":"Gummert","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Cardiac and Vascular Surgery (Heart and Diabetes Centre), North Rhine Westphalia , Bad Oeynhausen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-8620","authenticated-orcid":false,"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin, Germany"},{"name":"Department of Cardiovascular Surgery, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin , Berlin, Germany"},{"name":"Department of Health Sciences and Technology, ETH Zurich , Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8110-4009","authenticated-orcid":false,"given":"Bart","family":"Meyns","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Leuven , Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2153-2458","authenticated-orcid":false,"given":"Gloria","family":"Faerber","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena , Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4298-3792","authenticated-orcid":false,"given":"Davide","family":"Pacini","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna , Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-3175","authenticated-orcid":false,"given":"Evgenij","family":"Potapov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin , Berlin, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Berlin , Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"2023020713392016700_ezad013-B1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1093\/ejcts\/ezz098","article-title":"2019 EACTS Expert Consensus on long-term mechanical circulatory support","volume":"56","author":"Potapov","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B2","first-page":"971","article-title":"Reversibility of fixed pulmonary hypertension in left ventricular assist device support recipients","volume":"40","author":"Mikus","year":"2011","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B3","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.healun.2020.03.009","article-title":"Understanding the impact of mitral regurgitation at the time of LVAD implantation","volume":"39","author":"Pagani","year":"2020","journal-title":"J Heart Lung Transplant"},{"key":"2023020713392016700_ezad013-B4","doi-asserted-by":"crossref","first-page":"3891","DOI":"10.1002\/ehf2.12982","article-title":"MitraClip implantation followed by insertion of a left ventricular assist device in patients with advanced heart failure","volume":"7","author":"Kreusser","year":"2020","journal-title":"ESC Heart Fail"},{"key":"2023020713392016700_ezad013-B5","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.healun.2010.01.011","article-title":"Clinical management of continuous-flow left ventricular assist devices in advanced heart failure","volume":"29","author":"Slaughter","year":"2010","journal-title":"J Heart Lung Transplant"},{"key":"2023020713392016700_ezad013-B6","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/MAT.0b013e31829ff57d","article-title":"Mitral regurgitation and axial flow left ventricular assist device: a computer simulation study","volume":"59","author":"Jelenc","year":"2013","journal-title":"ASAIO J"},{"key":"2023020713392016700_ezad013-B7","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.athoracsur.2016.06.078","article-title":"Surgically corrected mitral regurgitation during left ventricular assist device implantation is associated with low recurrence rate and improved midterm survival","volume":"103","author":"Tanaka","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"2023020713392016700_ezad013-B8","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1093\/icvts\/ivx223","article-title":"Impact of concomitant mitral valve repair for severe mitral regurgitation at the time of continuous-flow left ventricular assist device insertion","volume":"25","author":"Sandoval","year":"2017","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2023020713392016700_ezad013-B9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.healun.2017.09.016","article-title":"Concomitant mitral valve procedures in patients undergoing implantation of continuous-flow left ventricular assist devices: an INTERMACS database analysis","volume":"37","author":"Robertson","year":"2018","journal-title":"J Heart Lung Transplant"},{"key":"2023020713392016700_ezad013-B10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jchf.2016.09.014","article-title":"Significance of residual mitral regurgitation after continuous flow left ventricular assist device implantation","volume":"5","author":"Kassis","year":"2017","journal-title":"JACC Heart Fail"},{"key":"2023020713392016700_ezad013-B11","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/ejcts\/ezx320","article-title":"The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardio-Thoracic Surgery (EACTS): second report","volume":"53","author":"de By","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B12","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/ejcts\/ezaa294","article-title":"Clinical impact and \u2018natural\u2019 course of uncorrected tricuspid regurgitation after implantation of a left ventricular assist device: an analysis of the European Registry for Patients with Mechanical Circulatory Support (EUROMACS)","volume":"59","author":"Veen","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B13","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1002\/sim.5984","article-title":"The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments","volume":"33","author":"Austin","year":"2014","journal-title":"Stat Med"},{"key":"2023020713392016700_ezad013-B14","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1093\/ejcts\/ezab144","article-title":"Propensity score-based analysis of long-term follow-up in patients supported with durable centrifugal left ventricular assist devices: the EUROMACS analysis","volume":"60","author":"Potapov","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B15","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.jacc.2015.02.009","article-title":"Secondary mitral regurgitation in heart failure: pathophysiology, prognosis, and therapeutic considerations","volume":"65","author":"Asgar","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"2023020713392016700_ezad013-B16","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.healun.2020.03.003","article-title":"Impact of left ventricular assist device implantation on mitral regurgitation: an analysis from the MOMENTUM 3 trial","volume":"39","author":"Kanwar","year":"2020","journal-title":"J Heart Lung Transplant"},{"key":"2023020713392016700_ezad013-B17","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1097\/MAT.0b013e31826e4267","article-title":"Left ventricular reverse remodeling with a continuous flow left ventricular assist device measured by left ventricular end-diastolic dimensions and severity of mitral regurgitation","volume":"58","author":"Morgan","year":"2012","journal-title":"ASAIO J"},{"key":"2023020713392016700_ezad013-B18","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1111\/aor.13295","article-title":"Impact of concomitant mitral valve surgery with LVAD placement","volume":"42","author":"Choi","year":"2018","journal-title":"Artif Organs"},{"key":"2023020713392016700_ezad013-B19","doi-asserted-by":"crossref","first-page":"e426\u201333","DOI":"10.1097\/CCM.0000000000005424","article-title":"Outcome of temporary circulatory support as a bridge-to-left ventricular assist device strategy in cardiogenic shock patients","volume":"50","author":"Bidaut","year":"2022","journal-title":"Crit Care Med"},{"key":"2023020713392016700_ezad013-B20","doi-asserted-by":"crossref","first-page":"E251","DOI":"10.1111\/aor.13638","article-title":"Continuous LVAD monitoring reveals high suction rates in clinically stable outpatients","volume":"44","author":"Gross","year":"2020","journal-title":"Artif Organs"},{"key":"2023020713392016700_ezad013-B21","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13019-021-01748-9","article-title":"Prognostic impact of functional mitral regurgitation prior to left ventricular assist device implantation","volume":"17","author":"Pausch","year":"2022","journal-title":"J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B22","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/j.jtcvs.2019.03.089","article-title":"Right ventricular function and residual mitral regurgitation after left ventricular assist device implantation determines the incidence of right heart failure","volume":"159","author":"Tang","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2023020713392016700_ezad013-B23","doi-asserted-by":"crossref","first-page":"ezab480","DOI":"10.1093\/ejcts\/ezab480","article-title":"The impact of left ventricular size on outcomes after centrifugal-flow left ventricular assist device implantation","volume":"62","author":"Molina","year":"2022","journal-title":"Eur J Cardiothorac Surg"},{"key":"2023020713392016700_ezad013-B24","doi-asserted-by":"crossref","first-page":"5458","DOI":"10.21037\/jtd-20-2778","article-title":"Pre-implant left ventricular dimension is not associated with worse outcomes after left ventricular assist device implantation","volume":"13","author":"Srinivasan","year":"2021","journal-title":"J Thorac Dis"},{"key":"2023020713392016700_ezad013-B25","doi-asserted-by":"crossref","first-page":"S1763","DOI":"10.21037\/jtd.2018.05.36","article-title":"MitraClip procedure prior to left ventricular assist device implantation","volume":"10","author":"Dogan","year":"2018","journal-title":"J Thorac Dis"},{"key":"2023020713392016700_ezad013-B26","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.14797\/DPYF8504","article-title":"Transcatheter mitral valve repair for severe, symptomatic mitral regurgitation in patients with left ventricular assist devices","volume":"17","author":"Raghunathan","year":"2021","journal-title":"Methodist Debakey Cardiovasc J"},{"key":"2023020713392016700_ezad013-B27","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.healun.2018.11.001","article-title":"Outcomes from a recovery protocol for patients with continuous-flow left ventricular assist devices","volume":"38","author":"Knierim","year":"2019","journal-title":"J Heart Lung Transplant"},{"key":"2023020713392016700_ezad013-B28","doi-asserted-by":"crossref","first-page":"3905","DOI":"10.1111\/jocs.15802","article-title":"Percutaneous mitral valve repair assisted by a catheter-based circulatory support device in a heart transplant patient","volume":"36","author":"Nersesian","year":"2021","journal-title":"J Card Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezad013\/48691629\/ezad013.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/2\/ezad013\/49118332\/ezad013.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/63\/2\/ezad013\/49118332\/ezad013.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T19:37:07Z","timestamp":1675798627000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezad013\/6986977"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,13]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezad013","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2023,1,13]]},"article-number":"ezad013"}}