Abstract
Introduction
Isolated tricuspid valve (TV) surgery is uncommonly performed and has historically
been associated with excessive operative mortality. We previously reported improved
short-term outcomes at our center. Understanding contemporary outcomes of isolated
TV surgery beyond the perioperative period is essential to properly benchmark outcomes
of newer transcatheter interventions.
Methods
Patients who underwent isolated TV surgery from 2007 to 2021 at a single institution
were retrospectively reviewed. Survival was estimated using the Kaplan–Meier method
and multivariable Cox proportional hazards regression modeling identified independent
risk factors for all-cause mortality.
Results
Among 173 patients undergoing isolated TV surgery, 103 (60%) underwent TV repair and
70 (40%) underwent TV replacement. Mean age was 60.3 ± 18.9 y and 55 (32%) were male.
The most common etiology of TV disease was functional (46%). In-hospital mortality
was 4.1% (7/173), with no difference between TV repair and replacement (P = 0.06). Overall survival at 1 y and 5 y was 78.3% (111/142) and 64.5% (53/82), respectively.
After median (interquartile range) follow-up of 2.0 (0.6-4.4) y, patients undergoing
TV repair experienced a higher unadjusted survival as compared to those undergoing
TV replacement (log-rank P = 0.02). However, after adjusting for covariates, TV replacement was not an independent
predictor of all-cause mortality (hazard ratio 1.40; 95% confidence interval, 0.71-2.76;
P = 0.33).
Conclusions
Isolated TV surgery can be performed with lower operative mortality than historically
reported. Establishing survival benchmarks from TV surgery is important in the era
of developing transcatheter interventions.
Keywords
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Article info
Publication history
Published online: November 02, 2022
Accepted:
October 3,
2022
Received in revised form:
August 15,
2022
Received:
April 27,
2022
Identification
Copyright
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