title: Durability of De Vega tricuspid valve annuloplasty for severe tricuspid regurgitation during left ventricular assist device implantation.
abstract: BACKGROUND
  Correction of significant tricuspid regurgitation (TR) at the time of continuous-flow (CF) left ventricular assist device (LVAD) implantation has been shown to be beneficial in several recently published studies. The most common technique is ring annuloplasty followed by valve replacement. Our center has primarily used the De Vega annuloplasty, and the durability of this repair is the focus of this study.
  
  
  METHODS
  This was a retrospective review of 35 consecutive patients who underwent CF LVAD implantation and De Vega tricuspid valve annuloplasty (TVA) for severe TR and were alive at 1 year. Echocardiograms were obtained preoperatively, intraoperatively, at discharge, and at 1 year after operation.
  
  
  RESULTS
  The TR in 32 of 35 patients (91.4%, group A) improved from severe preoperatively to insignificant at the time of discharge after De Vega TVA, and 3 patients (8.6%, group B) had moderate residual TR. At 1-year follow-up, 29 of 32 (90.6%) patients in group A had insignificant TR, 2 (6.3%) had moderate TR, and 1 (3.1%) had severe TR. In group B, 2 of 3 patients had no progression of their moderate TR at 1 year and 1 had severe TR. Overall, 2 of 35 (5.7%) patients had severe TR at 1 year after De Vega TVA and LVAD implantation.
  
  
  CONCLUSIONS
  We conclude from this consecutive cohort of patients undergoing CF LVAD implantation and De Vega TVA that this technique is very durable at 1 year and has the advantages of a shorter operative time relative to ring annuloplasty and decreased cost because a prosthetic implant is not used.
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: akhter@surgery.wisc.edu.
authors.forename: Shahab A
authors.initials: SA
authors.lastname: Akhter
authors.affiliation: Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: M Reza
authors.initials: MR
authors.lastname: Salabat
authors.affiliation: Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Philip
authors.affiliation: Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Tracy B
authors.initials: TB
authors.lastname: Valeroso
authors.affiliation: Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Russo
authors.affiliation: Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Rich
authors.affiliation: Department of Surgery, University of Chicago Medical Center, Chicago, Illinois.
authors.forename: Valluvan
authors.initials: V
authors.lastname: Jeevanandam
mesh_terms: D058385:Cardiac Valve Annuloplasty / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006353:Heart-Assist Devices; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*