Does concomitant tricuspid valve intervention at the time of left ventricular assist device placement for patients with significant tricuspid regurgitation lead to improved outcomes compared to isolated left ventricular assist device placement?

Ananya Mitra; Anthony Castleberry; Marian Urban; Aleem Siddique

doi:10.1093/icvts/ivae005

Does concomitant tricuspid valve intervention at the time of left ventricular assist device placement for patients with significant tricuspid regurgitation lead to improved outcomes compared to isolated left ventricular assist device placement?

Interdiscip Cardiovasc Thorac Surg. 2024 Feb 2;38(2):ivae005. doi: 10.1093/icvts/ivae005.

Authors

Ananya Mitra¹, Anthony Castleberry^{2

3}, Marian Urban^{2

3}, Aleem Siddique^{2

3}

Affiliations

¹ College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
² Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
³ Division of Cardiothoracic Surgery, University of Nebraska Medical Center, Omaha, NE, USA.

Abstract

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'In patients with advanced heart failure (HF) and moderate to severe functional tricuspid regurgitation (TR) undergoing left ventricular assist device (LVAD) placement is concomitant tricuspid valve intervention (TVI) superior for the clinical outcomes of survival, right ventricular failure, rehospitalizations for HF, functional status, and quality of life?' Altogether, 56 papers were found using the reported search, of which 12 papers represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Our search found no significant clinical benefit for concomitant TVI at the time of LVAD placement. We conclude that patient with moderate-to-severe TR should not routinely undergo concomitant TVI with LVAD placement.

Keywords: Left ventricular dysfunction; Treatment outcome; Tricuspid regurgitation; Ventricular assist device.