Mid-Term Outcome after Tricuspid Valve Replacement

Cheng, Yanmei; Mo, Shaoyan; Wang, Keke; Fan, Rui; Liu, Yunqi; Li, Si; Xi, Zhang; Yin, Shuo; Xu, Yingqi; Tang, Baozhen; Wu, Zhongkai

doi:10.21470/1678-9741-2019-0215

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…Around 0.5 -1% of these patients can also develop refractory post-cardiotomy cardiogenic shock not responsive to these measures, in which case, accelerated support such as ECMO is needed [39,40]. Patients with pre-operative right ventricular dysfunction are at higher risk of requiring intracardiac support, such as IABP and Impella, due to low cardiac output associated with right ventricular dysfunction [41]. In our study, patients who underwent open TVR were more likely to require an intra-aortic balloon pump (IABP) and Impella (although statistically insignificant) than TTVR.…”

Section: Discussionmentioning

confidence: 99%

National Estimates for the Percentage of all Readmissions With Demographic Features, Morbidity, Overall and Gender-specific Mortality of Transcutaneous vs Open Surgical Tricuspid Valve Replacement/Repair

Khan

Baqi

Ghumman

et al. 2023

Preprint

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Aims: To determine national estimates for the percentage of all readmissions with demographic features, length of stay, cost analysis, comorbidities, overall and gender-specific mortality, and complications of transcutaneous Tricuspid replacement/repair [TTVR] vs. open surgical tricuspid valve replacement/repair [Open TVR]. Methods: Data was extrapolated from the NRD databases 2015-19. Of the 75,266,750 (unweighted) cases recorded in the 2015 ? 2019 dataset, 429 had one or more of the percutaneous approach codes as per the ICD-10 data set, and 10077 had one or more of the open approach codes. Results: Overall, the number of cases performed each year through open TVR was higher than TTVR, but there was an increased trend towards the TTVR every passing year. TTVR was performed more in females and advanced age groups than open TVR. The length of stay and cost was lower in the TTVR group than in open TVR. Patients undergoing TTVR had more underlying comorbidities like CHF, HTN, and uncomplicated DM. Overall mortality was 3.49 % in TTVR vs. 6.09% in open TVR. Gender-specific analysis demonstrated higher female mortality in the open TVR compared to TTVR (5.45% vs. 3.03 %). Male mortality was statistically insignificant between the two groups (6.8%% vs. 4.3%, p-value 0.15%). Patients with TTVR had lower rates of complications than open TVR, except for arrhythmias, which were higher in TTVR. Patients undergoing open TVR required more intracardiac support, such as IABP and Impella, than TTVR. Conclusion: Transcatheter tricuspid valve replacement/repair is an emerging alternative to open surgical repair/replacement in patients with tricuspid valve diseases, especially tricuspid regurgitation. Despite having more underlying comorbidities, the TTVR group had lower in-hospital mortality, hospital cost, length of stay, and fewer complications than open TVR.

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Section: Discussionmentioning

confidence: 99%

National Estimates for the Percentage of all Readmissions With Demographic Features, Morbidity, Overall and Gender-specific Mortality of Transcutaneous vs Open Surgical Tricuspid Valve Replacement/Repair

Khan

Baqi

Ghumman

et al. 2023

Preprint

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“…In Table 4 , intraoperative risk factors including ACPBT and cTVR were new predictors for postoperative MODS besides CCr, BUN/BCr and PD, we also found PD (OR 4.69) and cTVR (OR 3.69) were the high-risk factors for postoperative MODS. Researchers showed surgical intervention for severe tricuspid valve disease is only indicated in symptomatic patients, or who have severe comorbidities [ 53 , 54 ]. Sharma et al reported that right ventricular failure is related to nearly 40% kidney failure and has an increased mortality risk after TVR [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

The multivariable prognostic models for severe complications after heart valve surgery

Liu

Xiao

Duan

et al. 2021

BMC Cardiovasc Disord

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Background To provide multivariable prognostic models for severe complications prediction after heart valve surgery, including low cardiac output syndrome (LCOS), acute kidney injury requiring hemodialysis (AKI-rH) and multiple organ dysfunction syndrome (MODS). Methods We developed multivariate logistic regression models to predict severe complications after heart valve surgery using 930 patients collected retrospectively from the first affiliated hospital of Sun Yat-Sen University from January 2014 to December 2015. The validation was conducted using a retrospective dataset of 713 patients from the same hospital from January 2016 to March 2017. We considered two kinds of prognostic models: the PRF models which were built by using the preoperative risk factors only, and the PIRF models which were built by using both of the preoperative and intraoperative risk factors. The least absolute shrinkage selector operator was used for developing the models. We assessed and compared the discriminative abilities for both of the PRF and PIRF models via the receiver operating characteristic (ROC) curve. Results Compared with the PRF models, the PIRF modes selected additional intraoperative factors, such as auxiliary cardiopulmonary bypass time and combined tricuspid valve replacement. Area under the ROC curves (AUCs) of PRF models for predicting LCOS, AKI-rH and MODS are 0.565 (0.466, 0.664), 0.688 (0.62, 0.757) and 0.657 (0.563, 0.751), respectively. As a comparison, the AUCs of the PIRF models for predicting LOCS, AKI-rH and MODS are 0.821 (0.747, 0.896), 0.78 (0.717, 0.843) and 0.774 (0.7, 0.847), respectively. Conclusions Adding the intraoperative factors can increase the predictive power of the prognostic models for severe complications prediction after heart valve surgery.

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Tricuspid valve replacement outcomes in a diverse variety of valve replacement cases: Mortality, mechanical versus biological – A single-center study

Patel,

Singh,

Parikh

et al. 2023

Heart India

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Background: The initial trial in tricuspid surgery is repair; however, replacement is done whenever the valve is badly diseased. Tricuspid valve replacement (TVR) as an isolated procedure and combined with other valve replacements presents a challenge as these patients are in the high-risk subset. Materials and Methods: The present retrospective study was performed using the medical records of 42 cases who underwent TVR since 2017 at our institute. The mean age of the participants was 36.3 ± 13.2 years and male–female was 66.7% and 33.3%, respectively. Isolated TVR was done in 35.7% of cases, associated with mitral valve replacement (MVR) in 38.1%, with aortic valve replacement (AVR) in 4.8%, triple-valve replacement (MV, TV, and AV) in 19.0%, and TVR associated with pulmonary valve replacement in 2.4% of cases. This diverse variety of valve replacement cases is the highlight of our study. About 30.9% of participants were undergoing the procedure as a redo surgery. Trial of repair was given in 33.3% of cases. Moreover, bioprosthesis and mechanical valve prosthesis were used in 73.8% and 26.2%, respectively. Results: Early mortality occurred in 8 (19.0%) cases. Cause of death common in all deaths was right ventricular failure in all cases 8/8 (100%) seconded by multi-organ failure in 7/8 cases (87.5%), previous cardiac surgery was a factor in 4/8 (50%) cases, mediastinitis occurred in 2/8 (25%) cases, and both arrhythmias and cerebrovascular accident happened in 1/8 (12.5%) case each. Mortality rate was 3/15 (20.0%) in cases of isolated TV surgery. Mortality rate for concomitant MVR was 3/15 (20.0%), and for concomitant AVR with MVR (triple-valve replacement) was 2/8 (25.0%). No early mortality happened in the concomitant AVR and concomitant pulmonary valve replacement group. Late mortality happened in 11/42 (26.2%) cases during follow-up. Total mortality as per the valve types has been 5/11 (45.5%) in the mechanical valve replacement group and 14/31 (45.2%) for the biological valve group. Conclusions: The patients who require TVR are usually high-risk surgical candidates with high early and late mortality. The most common cause of death was right ventricular failure in this study. TVR associated with other heart valve replacement increases the risk strata of the patient which is the highlight of our study. In the end, we conclude that we had 19.0% early (0–30 days) and 26.2% late mortality (0–1 year) making a composite of 45.2% mortality at the end of 1 year. No difference in the effect of mortality as per the valve type has been observed.

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Mid-Term Outcome after Tricuspid Valve Replacement

Cited by 3 publications

References 42 publications

National Estimates for the Percentage of all Readmissions With Demographic Features, Morbidity, Overall and Gender-specific Mortality of Transcutaneous vs Open Surgical Tricuspid Valve Replacement/Repair

National Estimates for the Percentage of all Readmissions With Demographic Features, Morbidity, Overall and Gender-specific Mortality of Transcutaneous vs Open Surgical Tricuspid Valve Replacement/Repair

The multivariable prognostic models for severe complications after heart valve surgery

Tricuspid valve replacement outcomes in a diverse variety of valve replacement cases: Mortality, mechanical versus biological – A single-center study

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