Should we touch tricuspid valve at the time of LVAD implantation? A young patient series.

Autor: Yavas S; Ankara Bilkent City Hospital, Cardiovascular Surgery, Ankara, Turkiye., Kervan U; Ankara Bilkent City Hospital, Cardiovascular Surgery, Ankara, Turkiye., Karahan M; Ankara Bilkent City Hospital, Cardiovascular Surgery, Ankara, Turkiye., Kocabeyoglu SS; Ankara Bilkent City Hospital, Cardiovascular Surgery, Ankara, Turkiye., Sert DE; Ankara Bilkent City Hospital, Cardiovascular Surgery, Ankara, Turkiye., Ersoy O; Ankara Etlik City Hospital, Cardiovascular Surgery, Ankara, Turkiye., Demirkan B; Ankara City Hospital, Cardiology, Ankara, Turkiye., Temizhan A; Ankara City Hospital, Cardiology, Ankara, Turkiye., Ozatik MA; Ankara Bilkent City Hospital, Cardiovascular Surgery, Ankara, Turkiye.
Jazyk: angličtina
Zdroj: The International journal of artificial organs [Int J Artif Organs] 2023 Sep; Vol. 46 (8-9), pp. 514-519. Date of Electronic Publication: 2023 Jun 19.
DOI: 10.1177/03913988231181604
Abstrakt: Background: The aim of the study is to compare the results of patients who had moderate or severe tricuspid insufficiency (TI) at the time of left ventricular assist device (LVAD) implantation that did not undergo intervention.
Methods: Between October 2013 and December 2019, 144 patients who did not undergo tricuspid valve repair (TVR) during LVAD implantation in our department were included in the study. The patients were divided into two groups according to the TI grade; Group 1: 106 patients (73.6%) with moderate TI and Group 2: 38 patients (26.4%) with severe TI. All patients were evaluated for mortality, need of inotrope, blood product transfusion, intensive care unit (ICU) stay, duration of mechanical ventilation, and early and late right ventricular failure (RVF). Minimally invasive technique was favored in patients with worse right ventricular (RV) function to prevent the need for postoperative RV support and bleeding.
Results: The mean ages of the patients in the Group 1 and Group 2 were 46 ± 15 years (82% male), and 45 ± 11.2 years (81.5% males), respectively. Post-operative duration of mechanical ventilation, ICU stay, blood loss, and reoperations were similar ( p  > 0.05). There was no significant difference in early RVF, pump thrombosis, stroke, bleeding, and 30-day mortality between groups ( p  > 0.05). Incidence of late RVF was higher in Group 2 ( p  < 0.05).
Conclusion: Although the risk of late RVF may increase in patients with preoperative severe TI, not intervening in TI during LVAD implantation does not cause adverse clinical outcomes in the early period.
Databáze: MEDLINE
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