Tricuspid Valve Disease: Surgical Outcome

Abstract

Outcomes after tricuspid valve surgery were initially extremely poor but have improved over time thanks to innovations in diagnostics, guidelines for treatment, emerging surgical experience and technical advances. This chapter provides a contemporary overview of patient and procedural characteristics of tricuspid valve repair and replacement and early and late outcomes in different settings, such as functional tricuspid regurgitation, rheumatic, congenital, carcinoid tricuspid valve disease, iatrogenic tricuspid valve damage, and finally endocarditis of the tricuspid valve. For this purpose a systematic literature review and meta-analysis was conducted including 132 studies published after 2005 and reporting on outcome after tricuspid valve surgery. This thorough review of reported experience with tricuspid valve repair and replacement reveals a strong variation in patient presentation and outcome among the various indications and highlights that tricuspid valve replacement is still associated with high early and late mortality. Innovations in the treatment of tricuspid valve disease are direly needed to improve outcome in this complicated patient population.