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Long-term outcomes of tricuspid valve repair or replacement in patients with a continuous-flow left ventricular

Simran Shah1, Chunhui Wang2, Gabriella Aponte Camacho1

  • 1Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.

The Journal of Thoracic and Cardiovascular Surgery
|September 7, 2025
PubMed

Insights

Concomitant tricuspid valve procedures (TVP) during left ventricular assist device (LVAD) implantation improve long-term survival and reduce tricuspid regurgitation (TR). Readmissions were similar between groups, indicating improved outcomes with combined procedures.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Heart Failure Management

Background:

  • Left ventricular assist devices (LVADs) are crucial for end-stage heart failure.
  • Tricuspid regurgitation (TR) is common in LVAD patients and can impact outcomes.
  • The role of concomitant tricuspid valve procedures (TVP) during LVAD implantation requires further clarification.

Purpose of the Study:

  • To evaluate the long-term effects of performing TVP concurrently with continuous-flow LVAD implantation.
  • To compare survival, rehospitalization rates, and TR progression in patients undergoing combined procedures versus LVAD alone.

Main Methods:

  • Retrospective review of 727 patients receiving HeartMate II or 3 LVADs (2004-2023).
  • Propensity score matching (PSM) created comparable cohorts of 90 patients each with and without concomitant TVP.
  • Primary outcomes included survival, rehospitalizations, and long-term TR.

Main Results:

  • The concomitant TVP group showed no significant difference in 1-year mortality compared to the LVAD-alone group.
  • After the first year, the TVP group experienced significantly lower mortality.
  • TR severity was significantly reduced over time in the TVP group, with similar readmission rates between groups.

Conclusions:

  • Concomitant TVP during LVAD implantation is associated with improved long-term survival.
  • Combined procedures effectively reduce the grade of tricuspid regurgitation.
  • Readmission rates remain comparable, suggesting TVP is safe and beneficial when performed with LVAD.
Abstract

Keywords:
concomitant valve repairleft ventricular assist devicetricuspid regurgitationtricuspid valve repair

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