Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

Nakanishi, Koki; Homma, Shunichi; Han, Jiho; Takayama, Hiroo; Colombo, P.C.; Yuzefpolskaya, M.; Garan, A.R.; Farr, Maryjane; Kurlansky, Paul; Tullio, Marco R. Di; Naka, Yoshifumi; Takeda, Koji

doi:10.1161/jaha.118.008813

Cited by 30 publications

(26 citation statements)

References 36 publications

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“…The univariate analysis revealed that dilated preoperative RVDd and elevated serum BUN levels were predictors of unexpected TAP. There have been various reports that dilated tricuspid annulus and/or RV were predictors of the occurrence of postoperative TR [ 18 ]. In our patients, those who required unexpected TAP had significantly higher serum BUN/Cr levels.…”

Section: Discussionmentioning

confidence: 99%

Impact of tricuspid regurgitation on late right ventricular failure in left ventricular assist device patients ~can prophylactic tricuspid annuloplasty prevent late right ventricular failure? ~

Nakazato

Yoshioka

Toda

et al. 2021

J Cardiothorac Surg

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Background In this study, we evaluated the prevalence of tricuspid regurgitation (TR) worsening in patients with left ventricular assist devices (LVADs) and its impact on late right ventricular (RV) failure. Methods We enrolled 147 patients of the 184 patients who underwent continuous-flow LVAD implantations from 2005 to March 2018. The prevalence of postoperative TR worsening and late RV failure were retrospectively evaluated. Results Concomitant tricuspid annuloplasty (TAP) was performed in 28 of 41 patients (68%) with preoperative TR greater than or equal to moderate (TR group) and in 23 of 106 patients (22%) with preoperative TR less than or equal to mild (non-TR group). Regarding the TR-free rates, despite receiving or not receiving concomitant TAP, there was no significant difference between the 2 groups (TR group: p = 0.37; non-TR group: p = 0.42). Of the 9 patients with postoperative TR greater than or equal to moderate, late RV failure developed in 3 patients, with TR worsening after RV failure in each case. During follow-up, 16 patients (11%) had late RV failure. As for the late RV failure-free rates, despite receiving or not receiving concomitant TAP, there was no significant difference between the 2 groups (TR group: p = 0.37; non-TR group: p = 0.96). Conclusions TR prognosis was preferable regardless of a patient receiving concomitant TAP; however, the presence of postoperative TR seemed to unrelated to late RV failure. Prophylactic TAP might not be necessary to prevent late RV failure.

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Section: Discussionmentioning

confidence: 99%

Impact of tricuspid regurgitation on late right ventricular failure in left ventricular assist device patients ~can prophylactic tricuspid annuloplasty prevent late right ventricular failure? ~

Nakazato

Yoshioka

Toda

et al. 2021

J Cardiothorac Surg

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show abstract

“…In addition, right heart failure after LVAD implantation reportedly increases mortality and complications (Dang et al 2006). Based on echocardiographic parameters of right heart failure, some previous reports suggested that tricuspid regurgitation was associated with right heart failure and mortality in patients with LVAD support in the long-term follow-up and recommended the use of concomitant tricuspid valve repair to prevent tricuspid regurgitation progression (Piacentino et al 2011;Maltais et al 2012;Han et al 2016;Nakanishi et al 2018). However, Cowger et al (2014) suggested that patients with moderate or worse aortic insufficiency was more likely to have right ventricular hypokinesis than those with less aortic insufficiency whereas they found no significant impact of aortic insufficiency development on right ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Aortic Insufficiency Causes Symptomatic Heart Failure during Left Ventricular Assist Device Support

Naganuma

Akiyama

Sasaki

et al. 2021

Tohoku J. Exp. Med.

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“…However, McCarthy et al [ 16 ] documented early failure in all types of TV annuloplasty repair in 14% of 790 annuloplasty patients within one month, furthermore, more severe preoperative TR was significantly associated with higher late TR risk. Nakanishi et al revealed residual TR significantly associated with worse survival [ 19 ] . All efforts should be made to eliminate this residual functional TR after left-sided heart operations [ 20 ] .…”

Section: Discussionmentioning

confidence: 99%

Mid-Term Outcome after Tricuspid Valve Replacement

Cheng¹,

Mo²,

Wang³

et al. 2020

Braz J Cardiovasc Surg

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Objective To evaluate the mid-term survival rate after tricuspid valve replacement (TVR). Methods We retrospectively studied 110 consecutive patients who underwent TVR from January 2007 to November 2017. A survival analysis was performed with the Kaplan-Meier method and the log-rank test. Results The median survival was 65.81 months. Mean age was 50 (range 39 to 59) years. Forty-eight patients (43.6%) were male, and 62 patients (56.4%) were female. Most of the patients (78.5%) were categorized into the New York Heart Association (NYHA) functional classes III/IV. Seventy-two patients (65.5%) had isolated TVR. Six-three patients (57.3%) had previously undergone heart surgery. The Kaplan-Meier survival rates at one year, three years, and five years were 59.0%±5%, 52.0%±6%, and 48.0%±6%, respectively. A Cox regression analysis demonstrated that the risk factors for mid-term mortality were advanced NYHA class (hazard ratio [HR] 2.430, 95% confidence interval [CI] 1.099-5.375, P =0.028), need for continuous renal replacement therapy (CRRT) treatment (HR 3.121, 95% CI 1.610-6.050, P =0.001), and need for intra-aortic balloon pump (IABP) treatment (HR 3.356, 95% CI 1.072-10.504, P =0.038). Conclusion In TVR, impaired cardiac function before the operation and a need for CRRT or IABP treatment after the operation is independently associated with increased mid-term mortality.

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Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

Cited by 30 publications

References 36 publications

Impact of tricuspid regurgitation on late right ventricular failure in left ventricular assist device patients ~can prophylactic tricuspid annuloplasty prevent late right ventricular failure? ~

Impact of tricuspid regurgitation on late right ventricular failure in left ventricular assist device patients ~can prophylactic tricuspid annuloplasty prevent late right ventricular failure? ~

Aortic Insufficiency Causes Symptomatic Heart Failure during Left Ventricular Assist Device Support

Mid-Term Outcome after Tricuspid Valve Replacement

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