Abstract
Background Tricuspid regurgitation (TR) is common and related to poor prognosis in patients
after left ventricular assist device (LVAD) implantation. The concomitant tricuspid
valve surgery (TVS) at the time of LVAD implantation on short and long-term outcomes
are controversial in current evidence.
Methods This is a single-center, observational, retrospective study. We enrolled patients
with moderate-to-severe TR who received LVAD implantations from 2009 to 2020. Postoperative
right ventricular failure (RVF), right ventricular assist device (RVAD) use, hospital
mortality, new-onset renal replacement therapy (RRT), and acute kidney injury (AKI)
were evaluated retrospectively.
Results Sixty-eight patients were included, 36 with and 32 without concomitant TVS. Baseline
characteristics did not differ between the two groups. Patients receiving TVS had
significantly increased incidences of postoperative RVF (52.8 vs. 25.0%, p = 0.019), RVAD implantation (41.7 vs. 18.8%, p = 0.041), and new-onset RRT (22.2 vs. 0%, p = 0.004). No difference in the incidence of AKI and hospital mortality was detected.
Besides, these associations remained consistent in patients who underwent LVAD implantation
via median sternotomy. During a median follow-up of 2.76 years, Kaplan–Meier analysis
and competing-risk analysis showed that TVS was not associated with better overall
survival in patients after LVAD implantation compared with the no-TVS group.
Conclusion Our study suggests that concomitant TVS failed to show benefits in patients receiving
LVAD implantation. Even worse, concomitant TVS is associated with significantly increased
incidences of RVF, RVAD use, and new-onset of RRT. Considering the small sample size
and short follow-up, these findings warrant further study.
Keywords
left ventricular assist device - heart failure - tricuspid valve surgery - retrospective
study
