Thorac Cardiovasc Surg 2013; 61 - OP24
DOI: 10.1055/s-0032-1332263

Tricuspid valve repair for moderate and severe tricuspid valve insufficiency in patients undergoing LVAD implantation

S Mahr 1, J Riebandt 1, T Haberl 1, J Horvat 2, A Rajek 3, G Laufer 1, H Schima 2, D Zimpfer 1
  • 1Medizinische Universität Wien/Klinik für Chirurgie, Abteilung für Herzchirurgie, Wien, Austria
  • 2Medizinische Universität Wien, Center for Med. Phys. and Biomed. Engineering, Wien, Austria
  • 3Medizinische Universität Wien, Herz-, Thorax-, Gefäßanästhesie, Wien, Austria

If moderate to severe tricuspid valve insufficiency (TI) should be reconstructed at the time of left ventricular assist device (LVAD) implantation remains a matter of debate as it may predispose for early postoperative right heart failure.

From 2008 to 2012 83 consecutive patients (54.9a ± 10.7a) received either a HMII or Heartware LVAD for terminal heart failure at our department. TR was performed in all patients with moderate to severe TI using an Edwards MC3 or Physio Tricuspid Annuloplasty Ring. Outcomes of patients with and without TR were analysed. Mean Follow up was 332 ± 231 days.

38 patients (45.7%) with moderate to severe TI underwent concomitant TR. All patients had no or only minimal TI after TR. 7 patients receiving TVR needed an ECMO as right ventricular support for 1.2 days ± 3. The in hospital mortality was comparable between patients with (7.9%) and without TR (11.1%). Long-term survival or bridge to transplant depicted by Kaplan-Meier analysis was comparable between patients with and without TR 24 months postoperatively (with TR 89%, w/o TR 76%; log-rank p = 0.48).

Tricuspid valve repair for moderate and severe insufficiency at the time of LVAD seems to reduce the risk for late right ventricular failure.