Objective:To evaluate the impact of left ventricular assist device(LVAD)implantation concomitant with mitral valve surgery(MVS)to intervene in preoperative significant mitral regurgitation(MR)on clinical prog-nosis.Methods:The PubMed,Embase,Cochrane Library,and Web of Science databases were searched for litera-ture on comparing LVAD implantation with or without concomitant MVS intervention for preoperative MR from inception to 10 October 2022.The primary study endpoint was all-cause mortality,and secondary endpoints were complications such as postoperative MR recurrence and readmission.Statistical analysis was performed using STATA 15.1 software.Results:A total of 7 retrospective cohort studies with 5 500 patients were included,and only 517(9.4％)patients received concomitant MVS.Meta-analysis showed that concomitant MVS did not in-crease postoperative early and mid-term mortality,with all-cause mortality rates of 4.3％and 4.9％at 30 days postoperatively in the MVS and No-MVS groups,respectively.There was a trend towards a decreased risk of all-cause mortality in the MVS group at 1 year(RR=0.83,95％CI:0.65-1.08,P=0.384),2 years(RR=0.83,95％CI:0.66-1.03,P=0.446),and 3 years(RR=0.78,95％CI:0.62-0.97,P=0.162)after surgery,but the differences were not statistically significant.Concomitant MVS did not increase the risk of mid-to long-term postoperative readmission,and the risk of readmission for heart failure was lower in the MVS group at 1 year(RR=0.33,95％CI:0.17-0.62,P=0.209)and 2 years(RR=0.34,95％CI:0.21-0.57,P=0.315)after sur-gery,but the differences were not statistically significant.Conclusion:Concomitant MVS with LVAD implanta-tion to intervene preoperative severe MR is safe and feasible,which does not increase the rate of early and mid-term postoperative all-cause mortality and readmission,and seems to reduce the risk of mid to long-term all-cause mortality and readmission.
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