Impact of the Kay Technique for Tricuspid Valve Repair Concurrent With Left Ventricular Assist Device Implantation on Valve Regurgitation Severity and Survival Outcomes

Objectives Concomitant tricuspid valve (TV) interventions during LVAD implantation are recommended to reduce right heart failure (RHF), yet data are inconclusive. We assessed whether the Kay technique for TV repair (TVR), concurrent with durable LVAD implantation, affects tricuspid regurgitation (TR) severity, right ventricular (RV) function, and survival outcomes. Methods We retrospectively analyzed 82 consecutive adult LVAD recipients between March 2015 and December 2022. Thirty‐nine underwent TVR via the Kay technique; 43 served as controls. Demographic, clinical, echocardiographic, hemodynamic, and survival data were collected. Echocardiographic assessments defined significant TR as moderate or greater; RV function and RHF were evaluated by established guidelines. Survival and freedom from late RHF were analyzed using Kaplan–Meier curves and log‐rank testing. Results Preoperatively, significant TR was present in 95% of TVR patients versus 79% of controls. At ≥ 12 months postimplant, nonsignificant TR occurred in 72% of TVR versus 82% of controls ( p = 0.30). No significant differences were observed in RV dysfunction or RHF incidence (> 12 months). Kaplan–Meier analysis showed no survival benefit with TVR (log‐rank p = 0.49). Conclusions TVR using the Kay technique during LVAD implantation did not meaningfully alter TR progression, RV function, or survival outcomes compared to LVAD alone. While initially effective postsurgery, benefits did not persist long‐term. Larger prospective studies are needed to confirm these findings.