Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes

M. Russo; M. Di Mauro; G. Saitto; A. Lio; P. Berretta; M. Taramasso; R. Scrofani; A. Della Corte; S. Sponga; E. Greco; M. Saccocci; A. Calafiore; G. Bianchi; D.B. Leviner; A. Biondi; E. Della Ratta; U. Livi; E. Sharoni; P. Werner; C. De Vincentiis; M. Di Eusanio; A. Kocher; C. Antona; F. Miraldi; G. Troise; M. Solinas; F. Maisano; G. Laufer; F. Musumeci; M. Andreas

doi:10.1016/j.athoracsur.2021.03.070

Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes

M. Russo^*, M. Di Mauro, G. Saitto, A. Lio, P. Berretta, M. Taramasso, R. Scrofani, A. Della Corte, S. Sponga, E. Greco, M. Saccocci, A. Calafiore, G. Bianchi, D.B. Leviner, A. Biondi, E. Della Ratta, U. Livi, E. Sharoni, P. Werner, C. De VincentiisM. Di Eusanio, A. Kocher, C. Antona, F. Miraldi, G. Troise, M. Solinas, F. Maisano, G. Laufer, F. Musumeci, M. Andreas

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches.METHODS The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who un- derwent isolated TV procedures (n = 406; age 56 +/- 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups.RESULTS After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% +/- 6% versus 78% +/- 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% +/- 5% versus 84% +/- 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% +/- 9% versus 86% +/- 5% (P - .024) comparing AH-TV replacement and BH-TV repair groups.CONCLUSIONS Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome. (C) 2022 by The Society of Thoracic Surgeons

Original language	English
Pages (from-to)	585-592
Number of pages	8
Journal	Annals of Thoracic Surgery
Volume	113
Issue number	2
DOIs	https://doi.org/10.1016/j.athoracsur.2021.03.070
Publication status	Published - 1 Feb 2022

Keywords

REGURGITATION
FORGOTTEN
REPAIR

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10.1016/j.athoracsur.2021.03.070

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Russo, M., Di Mauro, M., Saitto, G., Lio, A., Berretta, P., Taramasso, M., Scrofani, R., Della Corte, A., Sponga, S., Greco, E., Saccocci, M., Calafiore, A., Bianchi, G., Leviner, D. B., Biondi, A., Della Ratta, E., Livi, U., Sharoni, E., Werner, P., ... Andreas, M. (2022). Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes. Annals of Thoracic Surgery, 113(2), 585-592. https://doi.org/10.1016/j.athoracsur.2021.03.070

@article{d2e82a2f5f6b4b6aa4f3e0b4efbce8fa,

title = "Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes",

abstract = "BACKGROUND Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches.METHODS The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who un- derwent isolated TV procedures (n = 406; age 56 +/- 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups.RESULTS After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% +/- 6% versus 78% +/- 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% +/- 5% versus 84% +/- 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% +/- 9% versus 86% +/- 5% (P - .024) comparing AH-TV replacement and BH-TV repair groups.CONCLUSIONS Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome. (C) 2022 by The Society of Thoracic Surgeons",

keywords = "REGURGITATION, FORGOTTEN, REPAIR",

author = "M. Russo and {Di Mauro}, M. and G. Saitto and A. Lio and P. Berretta and M. Taramasso and R. Scrofani and {Della Corte}, A. and S. Sponga and E. Greco and M. Saccocci and A. Calafiore and G. Bianchi and D.B. Leviner and A. Biondi and {Della Ratta}, E. and U. Livi and E. Sharoni and P. Werner and {De Vincentiis}, C. and {Di Eusanio}, M. and A. Kocher and C. Antona and F. Miraldi and G. Troise and M. Solinas and F. Maisano and G. Laufer and F. Musumeci and M. Andreas",

note = "Funding Information: The study received no external funding and was supported by the Medical University of Vienna. Publisher Copyright: {\textcopyright} 2022 The Society of Thoracic Surgeons",

year = "2022",

month = feb,

day = "1",

doi = "10.1016/j.athoracsur.2021.03.070",

language = "English",

volume = "113",

pages = "585--592",

journal = "Annals of Thoracic Surgery",

issn = "0003-4975",

publisher = "Elsevier Science",

number = "2",

}

Russo, M, Di Mauro, M, Saitto, G, Lio, A, Berretta, P, Taramasso, M, Scrofani, R, Della Corte, A, Sponga, S, Greco, E, Saccocci, M, Calafiore, A, Bianchi, G, Leviner, DB, Biondi, A, Della Ratta, E, Livi, U, Sharoni, E, Werner, P, De Vincentiis, C, Di Eusanio, M, Kocher, A, Antona, C, Miraldi, F, Troise, G, Solinas, M, Maisano, F, Laufer, G, Musumeci, F & Andreas, M 2022, 'Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes', Annals of Thoracic Surgery, vol. 113, no. 2, pp. 585-592. https://doi.org/10.1016/j.athoracsur.2021.03.070

TY - JOUR

T1 - Beating Versus Arrested Heart Isolated Tricuspid Valve Surgery: Long-term Outcomes

AU - Russo, M.

AU - Di Mauro, M.

AU - Saitto, G.

AU - Lio, A.

AU - Berretta, P.

AU - Taramasso, M.

AU - Scrofani, R.

AU - Della Corte, A.

AU - Sponga, S.

AU - Greco, E.

AU - Saccocci, M.

AU - Calafiore, A.

AU - Bianchi, G.

AU - Leviner, D.B.

AU - Biondi, A.

AU - Della Ratta, E.

AU - Livi, U.

AU - Sharoni, E.

AU - Werner, P.

AU - De Vincentiis, C.

AU - Di Eusanio, M.

AU - Kocher, A.

AU - Antona, C.

AU - Miraldi, F.

AU - Troise, G.

AU - Solinas, M.

AU - Maisano, F.

AU - Laufer, G.

AU - Musumeci, F.

AU - Andreas, M.

PY - 2022/2/1

Y1 - 2022/2/1

N2 - BACKGROUND Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches.METHODS The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who un- derwent isolated TV procedures (n = 406; age 56 +/- 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups.RESULTS After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% +/- 6% versus 78% +/- 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% +/- 5% versus 84% +/- 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% +/- 9% versus 86% +/- 5% (P - .024) comparing AH-TV replacement and BH-TV repair groups.CONCLUSIONS Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome. (C) 2022 by The Society of Thoracic Surgeons

AB - BACKGROUND Isolated tricuspid valve (TV) surgery is a rare procedure generally considered at high risk for perioperative mortality and poor long-term outcomes. Surgical treatment can be performed with either an arrested heart (AH) or beating heart (BH) technique. The aim of this study was to compare the outcomes of isolated tricuspid surgery with 2 different approaches.METHODS The Surgical-Tricuspid Study is a multicenter international retrospective study enrolling adult patients who un- derwent isolated TV procedures (n = 406; age 56 +/- 16 years; 56% female) at 13 international sites. The AH and BH strategies were performed in 253 and 153 patients, respectively. Propensity score-matched analysis was used to compare groups.RESULTS After matching, 129 pairs were obtained and analyzed. The 30-day mortality rate was 6.2% versus 5.0% in the AH and BH groups, respectively (P = .9). The rates of acute renal failure requiring replacement therapy (10% versus 3%; P = .02) and stroke (1.6% versus 0%; P = .08) were numerically higher in the AH group. The 6-year survival rate was 67% +/- 6% versus 78% +/- 5% in the AH and BH groups, respectively (P = .18), whereas freedom from cardiac death was 75% +/- 5% versus 84% +/- 4% (P = .21). The 6-year composite cardiac end point of cardiac death and reoperation rate was 60% +/- 9% versus 86% +/- 5% (P - .024) comparing AH-TV replacement and BH-TV repair groups.CONCLUSIONS Isolated TV surgery performed with a BH strategy is a safe option and resulted in a trend of increased long-term survival and freedom from reoperation compared with the standard AH technique. Patients undergoing BH valve repair had the best long-term outcome. (C) 2022 by The Society of Thoracic Surgeons

KW - REGURGITATION

KW - FORGOTTEN

KW - REPAIR

U2 - 10.1016/j.athoracsur.2021.03.070

DO - 10.1016/j.athoracsur.2021.03.070

M3 - Article

C2 - 33831392

SN - 0003-4975

VL - 113

SP - 585

EP - 592

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

IS - 2

ER -