Study of the Clinical Impact of Surgical Correction of Tricuspid Insufficiency in Implantable LVAD Patients

Inclusion Criteria: 1. Participant or their legal representative has signed an informed consent 2. Over 18 years of age 3. Participant with advanced heart failure symptoms (Class III or IV) and preoperative mild tricuspid regurgitation who are scheduled for an implantable LVAD Exclusion Criteria: 1. Prior tricuspid valve repair 2. Any evidence of structural (chordal or leaflet) tricuspid valve disease 3. Technical obstacles, which pose an inordinately high surgical risk, in the judgment of the investigator 4. Existence of any ongoing mechanical circulatory support other than intra-aortic balloon counter pulsation 5. Body Mass Index (BMI) \> 45 6. Pregnancy 7. Presence of mechanical aortic valve that will not be converted to a bioprosthesis at time of LVAD implant 8. History of cardiac transplant or cardiomyoplasty 9. Psychiatric disease, irreversible cognitive dysfunction or psychosocial issues that are likely to impair compliance with the study protocol and LVAD management 10. Presence of active, uncontrolled infection 11. Evidence of intrinsic hepatic disease as defined by liver enzyme values 12. History of a stroke within 90 days prior to enrollment, or a history of cerebral vascular disease with significant (\> 80%) extra cranial stenosis 13. Need for chronic renal replacement therapy (e.g. chronic dialysis) 14. Participation in any other clinical investigation that is likely to confound study results or affect study outcome 15. Any condition, other than heart failure, that could limit survival to less than 1 year 16. Participant refuses to be enrolled in study 17. Institution inmates.