Key result
Current evidence does not support routine concomitant tricuspid valve surgery at the time of LVAD implantation, as functional tricuspid regurgitation frequently resolves after isolated left ventricular unloading.
Why the study?
Does tricuspid surgery at the time of LVAD implant prevent RV dysfunction and improve survival in patients with end-stage heart failure and tricuspid regurgitation?
Does tricuspid surgery at the time of LVAD implant prevent RV dysfunction and improve survival in patients with end-stage heart failure and tricuspid regurgitation?
Answers are grounded in this paper and cite their sources.
The surgical decision-making regarding tricuspid valve intervention at the time of LVAD implantation remains obscure, as historical cohort data cannot distinguish cause from effect.
Tricuspid regurgitation (TR) is a common finding in patients with end stage heart failure referred for implantation of left ventricular assist devices. While functional TR frequently resolves after left ventricular unloading, patients with residual and progressive TR demonstrate increased rates of RV dysfunction and poor survival. Criteria for intervention on the tricuspid valve have focused on the degree of tricuspid annular dilatation and the severity of tricuspid regurgitant volume. The surgical decision making regarding intervention on the tricuspid valve remains obscure and historical cohort data cannot distinguish cause from effect.
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Charles W. Hoopes (2022) conducted a review in End-stage heart failure with tricuspid regurgitation undergoing LVAD implantation. Concomitant tricuspid valve surgery vs. LVAD implantation alone was evaluated. Current evidence does not support routine concomitant tricuspid valve surgery at the time of LVAD implantation, as functional tricuspid regurgitation frequently resolves after isolated left ventricular unloading.
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