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Review
. 2025 Jun;13(6):901-911.
doi: 10.1016/j.jchf.2025.03.031.

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

Boaz Elad  1 , Emily Tat  1 , Gabriel Sayer  1 , Koji Takeda  1 , Michael I Brener  1 , Dor Lotan  1 , Daniel Burkhoff  2 , Susheel Kodali  1 , Rebecca Hahn  1 , Martin B Leon  1 , Nir Uriel  3
Affiliations
Review

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

Boaz Elad et al. JACC Heart Fail. 2025 Jun.

Abstract

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.

Keywords: left ventricular assist device; right ventricular dysfunction; transcatheter tricuspid therapies; tricuspid regurgitation.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Uriel is on the medical advisory board for Livemetric, Leviticus, and Revamp; and has received research grants from Abiomed and Abbott. Dr Sayer has received consulting fees from Abbott. Dr Brener is supported by institutional grants from Abiomed and Abbott; has received honoraria from Artract and Osprey Medical; and has consulted for Ventricord. Dr Kodali has received consultant honoraria from Abbott Vascular, Claret Medical, and Merrill LifeScience; and has served as an advisory board member for Biotrace Medical, MID, and Thubrikar Aortic Valve Inc. Dr Hahn has received speaker honoraria from Abbott Vascular, Baylis Medical Company Inc, Edwards Lifesciences, Medtronic USA Inc, and Philips. Dr Leon has received funding grants from Edwards Lifesciences Corporation; consulting or advisory and funding grants from Medtronic, Boston Scientific Corp, and Abbott; and consulting or advisory fees from W L Gore and Associates Inc Medical Products Division and Meril Life Sciences Pvt Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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