geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Concomitant tricuspid valve surgery during implantation of continuous-flow left ventricular assist devices: a Society of Thoracic Surgeons database analysis


, : Concomitant tricuspid valve surgery during implantation of continuous-flow left ventricular assist devices: a Society of Thoracic Surgeons database analysis. Journal of Heart and Lung Transplantation 33(6): 609-617

Performing concomitant tricuspid valve procedures (TVPs) in left ventricular assist device (LVAD) patients with significant pre-operative tricuspid regurgitation (TR) is controversial, and no studies have been large enough to definitively guide therapy. Between January 2006 and September 2012, 2,196 patients with moderate to severe pre-operative TR from 115 institutions underwent implantation of a continuous-flow left ventricular assist device (LVAD) as reported by The Society of Thoracic Surgeons National Database. Of these, 588 (27%) underwent a concomitant TVP. Inverse probability weighting based on propensity score was used to adjust for differences between the LVAD alone and LVAD+TVP groups, and outcomes were compared. Most patients in the LVAD+TVP group underwent an annuloplasty alone (81.1%). Concomitant TVP did not affect risk of post-operative right VAD insertion (risk ratio [RR], 0.81; 95% confidence interval [CI], 0.49-1.36; p = 0.4310) or death (RR, 0.95; 95% CI, 0.68-1.33; p = 0.7658). However, TVP was associated with an increased risk for post-operative renal failure (RR, 1.53; 95% CI, 1.13-2.08; p = 0.0061), dialysis (RR, 1.49; 95% CI, 1.03-2.15; p = 0.0339), reoperation (RR, 1.24; 95% CI, 1.07-1.45; p = 0.0056), greater total transfusion requirement (RR, 1.03; 95% CI, 1.01-1.05; p = 0.0013), and hospital length of stay > 21 days (RR, 1.29; 95% CI, 1.16-1.43; p < 0.0001). Time on the ventilator and intensive care unit length of stay were also significantly prolonged for the LVAD+TVP group. Performing a concomitant TVP for continuous-flow LVAD patients with moderate to severe TR did not reduce early death or right VAD requirement and was associated with worse early post-operative outcomes. These data caution against routine concomitant TVP based solely on degree of pre-operative TR and suggest that additional selection criteria are needed to identify those patients in whom concomitant TVP may prevent post-operative right ventricular failure.

US$19.90

PMID: 24661682

DOI: 10.1016/j.healun.2014.01.861


Other references

Paliwal, K.V.; Maliwal, G.L., 1975: Effect of salts on the growth and mineral nutrition of cabbage (Brassica oleracea) in soil and sand culture. The effect of salts (3-18 mmho/cm) on the growth and chemical composition of cabbage was studied in a greenhouse and field experiment on a sandy loam soil. Growth of cabbage and uptake of N, P, K, Ca and Mg decreased, and Na uptake increased, with...

Krapp, A.; Del Rosario, E.Cano.; Simanis, V., 2011: The role of Schizosaccharomyces pombe dma1 in spore formation during meiosis. Meiosis is a specialised form of the cell cycle that gives rise to haploid gametes. In Schizosaccharomyces pombe, the products of meiosis are four spores, which are formed by encapsulation of the four meiosis II nuclei within the cytoplasm of the...

Wirotius, J.M.; Hardy, J.M.; Gounet, M.; Boit, E.; Tadlaoui, A., 1993: Circular fixator (Ilizarov, Sequoia) in orthopedic surgery: Review of a group of 45 patients. The department of orthopedic surgery in the Brive's Hospital (Brive, France) uses a fixator called the "Sequoia". It is a circular external fixator which is similar to the Ilizarov technique. Forty-five patients have been reviewed a...

Throckmorton, T.; Windle, P.E., 2010: Evidence-based case management practice-part II: meta-analysis: a primer for case managers. This article aims to (1) describe the steps in the development of a meta-analysis, (2) discuss the use of meta-analysis in developing an evidence base for case management practice, and (3) provide some basic guidelines for evaluating the meta-anal...

Groot, Wj-De, 1989: Technology transfer in Saskatchewan: operational use of the Canadian forest fire danger rating system. Proceedings of the 10th Conference on Fire and Forest Whitewood = Compte rendu du 10ieme Congress sur les incendies et la meterologie forestiere editeurs DC Maiver H Auld R Whitewood: 332

Weiner, J.A.; Chun, J., 1998: Lysophosphatidic acid and its G-protein coupled receptor VZG-1/LPA1 constitute a novel signaling pathway in myelin-producing cells. Society for Neuroscience Abstracts 24(1-2): 50

Hashimoto, K.; Misato, T., 1965: Studies On The Microsomes Of Yeast Cells Treated With Blasticidin S. Journal of Antibiotics 18: 77-81

Barie, P.S.; Hydo, L.J.; Fischer, E., 1995: Comparison of APACHE II and III scoring systems for mortality prediction in critical surgical illness. To determine whether the Acute Physiology and Chronic Health Evaluation III (APACHE III), an updated version of APACHE II that contains a larger number of postoperative patients in the normative database, offers better prediction in critical surgi...

Suzuki, O.; Yagi, K., 1976: Distribution of type A and B monamine oxidase activities in the central nervous system of rat and chick. The distribution of type A and B monamine oxidase (MAO) activities in the central nervous system (CNS) of rat and chick was investigated using 5-hydroxytryptamine and beta-phenylethylamine as specific substrates. The distribution of type A MAO was...

Berry, F.B.; Mirzayans, F.; Walter, M.A., 2006: Regulation of FOXC1 stability and transcriptional activity by an epidermal growth factor-activated mitogen-activated protein kinase signaling cascade. Mutations in the FOXC1 transcription factor gene result in Axenfeld Rieger malformations, a disorder that affects the anterior segment of the eye, the teeth, and craniofacial structures. Individuals with this disorder possess an elevated risk for...