Isolated tricuspid valve surgery; long-term outcomes based on Tehran Heart Center data bank report

Seyed Hosssein Ahmadi Tafti,Abbas Salehi Omran,Negar Omidi,Shiva Shoja,Farshid Alaeddini,Mahmood Shirzad,Mehrdad Mahalleh,Jamshid Bagheri

doi:10.1186/s13019-021-01394-1

Abstract

BackgroundGiven that isolated tricuspid valve (TV) repair or replacement is performed relatively rarely, we sought to evaluate the rate of long-term mortality and readmission following this surgery.MethodsThe current study was conducted in Tehran Heart Center on patients who underwent isolated TV repair or replacement between 2010 and 2018. Totally, 197 patients (repair = 150 vs replacement = 47) were included in our study and were then followed right after surgery for a median of 8 years to assess the incidence of postoperative events, readmission, and all-cause mortality.ResultsThe final analysis was conducted on 197 patients at a mean age of 44.4 ± 13.8 years. Most of the patients were female (56.9%). Ejection fraction, TAPSE, and right ventricular function improved in both groups after TV surgery. Length of stay in the intensive care unit per hour and hospitalization per day were higher in the replacement group and compared to the repair group (158.34 vs. 55.11 and 18.21 vs. 9.34, respectively). In-hospital mortality occurred in 20 patients, of whom 15 had TV replacement. Readmission occurred in five (2.5%) patients,all were in the repair group.ConclusionsThe result of this single-center study showed that TV replacement is associated with a higher rate of postoperative events and all-cause mortality compared to TV repair. Whereas, repair group had a higher rate of readmission. Therefore, the overwhelming tendency is toward repair; nonetheless, no hesitation is permissible if a replacement is adjudged to confer a better outcome for the patient.

Highlights

Tricuspid valve (TV) disease is far less common than is mitral or aortic valve involvement, and it is often ignored because its regurgitation or stenosis can be well tolerated [1,2,3]
Population The study population was comprised of 197 patients at a mean age of 44.4 ± 13.8 years and a mean body mass index of 24.9 ± 4.4 kg/cm2 who underwent tricuspid valve (TV) repair or replacement either solely or with concomitant atrial septal defect (ASD) surgical closure
All the patients were investigated for postoperative complications, readmission, and 30-dayin-hospital mortality and were included in the final analysis

Summary

Introduction

Tricuspid valve (TV) disease is far less common than is mitral or aortic valve involvement, and it is often ignored because its regurgitation or stenosis can be well tolerated [1,2,3]. TV regurgitation that leads to surgery can be either organic or secondary. The severity of TV dysfunction tends to rise steadily, and it is mostly diagnosed when patients develop significant symptoms [4]. The majority of patients are controlled with pharmacotherapy until it fails, necessitating their referral to surgeons for decision-making on the repair or replacement of the valve based on the symptoms and severity of the disease. Given that isolated tricuspid valve (TV) repair or replacement is performed relatively rarely, we sought to evaluate the rate of long-term mortality and readmission following this surgery

Methods

Results

Discussion

Conclusion