Should We Touch Tricuspid Valve at the Time of LVAD

Abstract

<h3>Purpose</h3> The optimal management of tricuspid regurgitation (TR) in patients undergoing left ventricular assist device (LVAD) implantation is controversial. The aim of the study is to compare outcomes of the patients who doesn't repair with moderate TR and severe TR on LVAD patient. <h3>Methods</h3> From October 2013 and December 2019, included 144 patients who without tricuspid repair (TVR) at the time of LVAD implantation at our department. Patients were divided into two groups according to the TR; Of 144 patients, 106 have moderate TR (group 1) and 38 with severe TR (group2). All patients were evaluated for mortality, need of inotrope, blood product transfusion, intensive care unit (ICU) stay, time on mechanical ventilation, and postoperative and late right ventricular failure (RVF). Minimally Invasive technique was favored in patients with worse RV function to prevent the need for postoperative RV support and bleeding. <h3>Results</h3> Preoperative baseline characteristics of the two groups were similar. Survival was not significantly different between the groups (P>0.05). Incidence of late RVF was high in severe TR group (P<0.05). Operative and postoperative outcomes were summarized in table 1. <h3>Conclusion</h3> A perfect implant of the LVAD and minimal bleeding is much more important than the TVR. TVR can be neglected during minimally invasive surgery. Incidence of late RVF was high in severe TR group. Further study is necessary to determine what factors lead to recurrence of late TR in LVAD patients both with and without TVR.