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Cited by 3 publications
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OBJECTIVES The interest in isolated tricuspid valve disease has rapidly increased recently. However, clinical trials and registry data are rare in the surgical literature. This study aimed to describe the early and long-term outcomes of a real-world experience in isolated tricuspid procedures comparing repair and replacement strategies. METHODS The Surgical-Tricuspid study is a multicentre retrospective study that enrolled adult patients who had undergone isolated tricuspid valve surgery at 13 international sites. Propensity score-matched analysis was used to compare repair versus replacement. RESULTS A cohort of 426 patients was enrolled [mean age: 55 (16) years; 56% female]. After matching, 175 comparable pairs were analysed. Preoperative left ventricular ejection fraction was 55(9) vs 56(9) (P = 0.8) while moderate–severe tricuspid regurgitation was present in 95% of cases. The 30-day mortality rate was 4.0% vs 8.0% in the repair and replacement groups, respectively (P = 0.115). The rates of re-exploration for bleeding (6.9% vs 13.1% P = 0.050), permanent pacemaker implantation (5.1% vs 12.0%; P = 0.022) and blood transfusion (46% vs 62%; P = 0.002) were higher in the replacement group. Cumulative survival rates at 3, 5 and 7 years in the repair group were 84 (3)%, 75 (4)% and 56 (9)% vs 71 (4)%, 66 (5)% and 58 (5)% in the replacement group (P = 0.001) while cumulative incidence for reoperation at 10 years did not differ between groups [repair 10 (1)% vs replacement 9 (1)%; P = 0.469]. CONCLUSIONS The data from the Surgical-Tricuspid study reported a high risk for patients undergoing tricuspid surgery. Isolated valve repair offered reduced early and late mortality with no difference regarding reoperation rate when compared with replacement.
OBJECTIVES The interest in isolated tricuspid valve disease has rapidly increased recently. However, clinical trials and registry data are rare in the surgical literature. This study aimed to describe the early and long-term outcomes of a real-world experience in isolated tricuspid procedures comparing repair and replacement strategies. METHODS The Surgical-Tricuspid study is a multicentre retrospective study that enrolled adult patients who had undergone isolated tricuspid valve surgery at 13 international sites. Propensity score-matched analysis was used to compare repair versus replacement. RESULTS A cohort of 426 patients was enrolled [mean age: 55 (16) years; 56% female]. After matching, 175 comparable pairs were analysed. Preoperative left ventricular ejection fraction was 55(9) vs 56(9) (P = 0.8) while moderate–severe tricuspid regurgitation was present in 95% of cases. The 30-day mortality rate was 4.0% vs 8.0% in the repair and replacement groups, respectively (P = 0.115). The rates of re-exploration for bleeding (6.9% vs 13.1% P = 0.050), permanent pacemaker implantation (5.1% vs 12.0%; P = 0.022) and blood transfusion (46% vs 62%; P = 0.002) were higher in the replacement group. Cumulative survival rates at 3, 5 and 7 years in the repair group were 84 (3)%, 75 (4)% and 56 (9)% vs 71 (4)%, 66 (5)% and 58 (5)% in the replacement group (P = 0.001) while cumulative incidence for reoperation at 10 years did not differ between groups [repair 10 (1)% vs replacement 9 (1)%; P = 0.469]. CONCLUSIONS The data from the Surgical-Tricuspid study reported a high risk for patients undergoing tricuspid surgery. Isolated valve repair offered reduced early and late mortality with no difference regarding reoperation rate when compared with replacement.
Background Surgery for tricuspid valve ( TV ) diseases is associated with poor prognosis, but few studies have described the long‐term outcomes by comparing TV repair and replacement in isolated and concomitant TV surgeries separately. Methods and Results Between 2000 and 2013, adult patients who underwent TV repair or replacement surgeries were identified from the Taiwan National Health Insurance Research Database. Outcomes of interest included all‐cause mortality, composite outcome, and readmission attributable to any cause. Inverse probability of treatment weighting was used to reduce confounding effects. A total of 2644 patients with a mean follow‐up of 4.9 years were included. Of them, 12.6% and 87.4% underwent isolated and concomitant TV surgery, respectively. The in‐hospital mortality rates for isolated and concomitant TV surgery were 8.7% and 8.6%, respectively, whereas all‐cause mortality rates were 41.7% and 36.8%, respectively. Compared with TV replacement, TV repair demonstrated significantly lower risks of all‐cause mortality (concomitant: hazard ratio [ HR ], 0.76; 95% CI, 0.59–0.99), composite outcome (isolated: subdistribution HR , 0.55; 95% CI, 0.35–0.89; concomitant: subdistribution HR , 0.63; 95% CI, 0.46–0.86), and readmission (isolated: subdistribution HR , 0.64; 95% CI, 0.46–0.91; concomitant: subdistribution HR , 0.72; 95% CI, 0.60–0.86), except insignificant difference in all‐cause mortality in isolated surgery. Conclusions Compared with replacement, TV repair is associated with better short‐ and long‐term outcomes in both isolated and concomitant TV surgery. However, further prospective clinical trials are warranted.
Objectives: Functional tricuspid regurgitation (TR) usually occurs with previous cardiovascular surgery, which causes right-side heart failure and affects patient prognosis. Thus, we aimed to assess the risk and outcomes of isolated tricuspid valve replacement (TVR) after cardiovascular surgery. Methods: We reviewed our hospital medical records and found 107 patients, who had undergone TVR following cardiovascular surgery from June 2009 to November 2017. Follow up was performed by telephone calls, with a mean follow up of 51 months (one to 120 months). Previous surgical procedures of all patients were recorded, and we compared the differences in baseline and preoperative characteristics between the survival and non-survival groups by univariate analysis. Furthermore, logistic regression analysis was performed to identify the risk factors. The variables with a P value < .05 on univariate analysis were entered into a multivariate analysis using stepwise selection. Results: TVR was performed in 107 patients, including 89 survivors and 18 non-survivors during the follow up. There were 38 male and 69 female patients, and the mean age was 53.55 years. Hospital mortality was 16.8% (18/107). The APACHE II (P < .001) and mechanical ventilation time (P = .001) were higher in the non-survival group. The values of B-type natriuretic peptide (BNP), total bilirubin (TB), and blood urea nitrogen (BUN) before and after the operation and some preoperative values were different between the two groups (P < .05). The logistic regression analysis showed that APACHE II score, mechanical ventilation time, preoperative albumin, and postoperative TB were risk factors for TVR after cardiovascular surgery. Conclusions: Reoperation tricuspid valve replacement is associated with high operative mortality. High APACHE II scores, mechanical ventilation time and postoperative TB were associated with increased short-term mortality risk, while high preoperative albumin levels decreased the risk. Positive reoperation for tricuspid valve prosthesis dysfunction can obtain satisfactory therapeutic effects, and survivors could benefit from the surgery.
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