Tricuspid Regurgitation in Left Ventricular Assist Device: Learning From the Past, Looking Into the Future.

The presence of tricuspid regurgitation (TR) in patients with heart failure is associated with poor outcomes. Similarly, TR in patients with durable left ventricular assist device (LVAD) support is associated with increased morbidity and mortality. The role of tricuspid valve (TV) intervention to correct TR at the time of LVAD implantation remains uncertain because multiple studies thus far have shown conflicting results on clinical outcomes. This review discusses the mechanism of TR in LVAD recipients, the hemodynamic effects of TR after LVAD implantation, and the significance of corrected and uncorrected TR in the context of LVAD support. It also examines predictors of TR following LVAD implantation and highlights the discrepancies and gaps in the existing published reports. Finally, the review evaluates the potential role of novel transcatheter tricuspid therapies in these patients.