Postoperative Outcome of Isolated Tricuspid Valve Operation Using Arrested-Heart or Beating-Heart Technique

Abstract

Tricuspid valve (TV) operations can be done with either a beating-heart or arrested-heart technique. We herein report the postoperative outcome of patients with isolated TV operations performed with a beating heart or arrested heart, having a closer look at echocardiographic results after TV repair, postoperative incidence of pacemaker implantations, neurologic complications, survival, and freedom from TV-related reoperation. We present a retrospective analysis of 105 patients who underwent isolated TV operations with a beating-heart (n=63) or arrested-heart technique (n=42). Mean patient age was 61.2±15.1 years. Male patients were 41.9% of the total, and the average log EuroSCORE was 12.4%±11.4%. Redo operations made up 51.4% of the total. Follow-up was 95% complete, with a mean duration of 32.0±32.6 months. Overall operative mortality was 8.6%. Five-year survival was 68.8%±7.1% versus 66.3%±9.1% for patients with beating-heart versus arrested-heart operations (p=0.9). During follow-up, 7 patients underwent TV reoperations, resulting in a 5-year event-free survival rate of 90.1%±5.9% for patients with beating-heart and 84.0%±6.7% for patients with arrested-heart operations. There was no significant difference regarding postoperative echocardiographic results after TV repair, postoperative pacemaker implantations, or neurologic outcome. Although both cohorts were very heterogeneous and difficult to compare, our results show that both surgical strategies for TV repair have good results regarding postoperative survival, neurologic complications, and postoperative indications for a pacemaker. TV repair with the beating-heart technique has excellent results and can be safely accomplished in a minimally invasive manner.