Outcomes in patients who underwent a concomitant tricuspid valve procedure during left ventricular assist device implantation

Andre Critsinelis, Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Gabriel Loor, O. H. Frazier, Jeffrey Morgan

Research output: Contribution to journalArticle

Abstract

Background: Study findings have been inconsistent regarding whether a concomitant tricuspid valve replacement or repair performed concurrently with continuous-flow left ventricular assist device (CF-LVAD) implantation has additive clinical benefit in patients with severe tricuspid valve regurgitation (TR). Aim of Study: To determine the effect of performing a concomitant tricuspid valve procedure (TVP) at the time of CF-LVAD implantation on patient outcomes. Methods: We retrospectively reviewed our single-institution experience in 526 patients who underwent primary implantation of a CF-LVAD between November 2003 and March 2016. We identified 59 (11.2%) patients who had severe TR at the time of implantation and analyzed the effect of performing a concomitant TVP at the time of CF-LVAD implantation on the rate of survival, incidence of postoperative right heart failure (RHF), recurrence of TR, and incidence of 30-day readmission. Results: We did not observe a significant difference in the overall survival rate (P =.51), incidence of postoperative RHF (P =.26), or recurrence of TR (P =.73) between patients with severe TR who underwent a TVP and those who did not at the time of CF-LVAD implantation. However, the incidence of 30-day readmission was significantly lower in patients who underwent a TVP than in those who did not (P =.002). Conclusions: Performing a concomitant TVP at the time of CF-LVAD implantation did not improve patient outcomes but reduced the incidence of 30-day readmission.

Original languageEnglish (US)
Pages (from-to)1458-1464
Number of pages7
JournalJournal of Cardiac Surgery
Volume34
Issue number12
DOIs
StatePublished - Dec 1 2019

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Heart-Assist Devices
Tricuspid Valve
Tricuspid Valve Insufficiency
Incidence
Survival Rate
Heart Failure
Recurrence

Keywords

  • heart failure
  • left ventricular assist device
  • outcomes
  • tricuspid valve regurgitation

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes in patients who underwent a concomitant tricuspid valve procedure during left ventricular assist device implantation. / Critsinelis, Andre; Kurihara, Chitaru; Kawabori, Masashi; Sugiura, Tadahisa; Loor, Gabriel; Frazier, O. H.; Morgan, Jeffrey.

In: Journal of Cardiac Surgery, Vol. 34, No. 12, 01.12.2019, p. 1458-1464.

Research output: Contribution to journalArticle

Critsinelis, Andre ; Kurihara, Chitaru ; Kawabori, Masashi ; Sugiura, Tadahisa ; Loor, Gabriel ; Frazier, O. H. ; Morgan, Jeffrey. / Outcomes in patients who underwent a concomitant tricuspid valve procedure during left ventricular assist device implantation. In: Journal of Cardiac Surgery. 2019 ; Vol. 34, No. 12. pp. 1458-1464.
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abstract = "Background: Study findings have been inconsistent regarding whether a concomitant tricuspid valve replacement or repair performed concurrently with continuous-flow left ventricular assist device (CF-LVAD) implantation has additive clinical benefit in patients with severe tricuspid valve regurgitation (TR). Aim of Study: To determine the effect of performing a concomitant tricuspid valve procedure (TVP) at the time of CF-LVAD implantation on patient outcomes. Methods: We retrospectively reviewed our single-institution experience in 526 patients who underwent primary implantation of a CF-LVAD between November 2003 and March 2016. We identified 59 (11.2{\%}) patients who had severe TR at the time of implantation and analyzed the effect of performing a concomitant TVP at the time of CF-LVAD implantation on the rate of survival, incidence of postoperative right heart failure (RHF), recurrence of TR, and incidence of 30-day readmission. Results: We did not observe a significant difference in the overall survival rate (P =.51), incidence of postoperative RHF (P =.26), or recurrence of TR (P =.73) between patients with severe TR who underwent a TVP and those who did not at the time of CF-LVAD implantation. However, the incidence of 30-day readmission was significantly lower in patients who underwent a TVP than in those who did not (P =.002). Conclusions: Performing a concomitant TVP at the time of CF-LVAD implantation did not improve patient outcomes but reduced the incidence of 30-day readmission.",
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AU - Loor, Gabriel

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