TY - JOUR
T1 - Mid-term outcomes of isolated tricuspid valve surgery according to preoperative clinical and functional staging
AU - Sala, A.
AU - Lorusso, R.
AU - Zancanaro, E.
AU - Carino, D.
AU - Bargagna, M.
AU - Bisogno, A.
AU - Lapenna, E.
AU - Ruggeri, S.
AU - Meneghin, R.
AU - Schiavi, D.
AU - Buzzatti, N.
AU - Denti, P.
AU - Monaco, F.
AU - Agricola, E.
AU - Maisano, F.
AU - Alfieri, O.
AU - Castiglioni, A.
AU - De Bonis, M.
PY - 2022/7/11
Y1 - 2022/7/11
N2 - OBJECTIVES: This study aimed at assessing mid-term outcomes of patients undergoing isolated tricuspid valve (TV) surgery based on a preoperative baseline clinical and functional classification.METHODS: All patients treated with isolated TV repair or replacement from March 1997 to May 2020 at a single institution were retrospectively reviewed and assessed for mid-term postoperative outcome according to a novel classification [stages 1-5 related to the absence or presence and extent of right heart failure (RHF)]. Kaplan-Meier survival curves were used to estimate mid-term survival. Competing risk analysis for time to cardiac death and hospitalizations for RHF were also carried out.RESULTS: Among the 172 patients included, 129 (75%) underwent TV replacement and 43 (25%) TV repair. At follow-up (median 4.2 years [2.1-7.5]), there were 23 late deaths. At 5 years, overall survival was 100% in stage 2, 88 +/- 4% in stage 3 and 60 +/- 8% in stages 4-5 (P = 0.298 and P = 0.001, respectively). Cumulative incidence function of cardiac death at 5 years was 0%, 8.6 +/- 3.76% and 13.2 +/- 5% for stages 2, 3 and 4 and 5, respectively. At follow-up, cumulative incidence function of re-hospitalizations for RHF was 0% for stage 2, 20 +/- 5% for stage 3 and 20 +/- 6.7% for stages 4 and 5 (P = 0.118 and P = 0.039, respectively).CONCLUSIONS: Both short- and mid-term outcomes support early referral for surgery in isolated TV disease, with excellent survival at 5 years and no further hospitalizations for RHF.
AB - OBJECTIVES: This study aimed at assessing mid-term outcomes of patients undergoing isolated tricuspid valve (TV) surgery based on a preoperative baseline clinical and functional classification.METHODS: All patients treated with isolated TV repair or replacement from March 1997 to May 2020 at a single institution were retrospectively reviewed and assessed for mid-term postoperative outcome according to a novel classification [stages 1-5 related to the absence or presence and extent of right heart failure (RHF)]. Kaplan-Meier survival curves were used to estimate mid-term survival. Competing risk analysis for time to cardiac death and hospitalizations for RHF were also carried out.RESULTS: Among the 172 patients included, 129 (75%) underwent TV replacement and 43 (25%) TV repair. At follow-up (median 4.2 years [2.1-7.5]), there were 23 late deaths. At 5 years, overall survival was 100% in stage 2, 88 +/- 4% in stage 3 and 60 +/- 8% in stages 4-5 (P = 0.298 and P = 0.001, respectively). Cumulative incidence function of cardiac death at 5 years was 0%, 8.6 +/- 3.76% and 13.2 +/- 5% for stages 2, 3 and 4 and 5, respectively. At follow-up, cumulative incidence function of re-hospitalizations for RHF was 0% for stage 2, 20 +/- 5% for stage 3 and 20 +/- 6.7% for stages 4 and 5 (P = 0.118 and P = 0.039, respectively).CONCLUSIONS: Both short- and mid-term outcomes support early referral for surgery in isolated TV disease, with excellent survival at 5 years and no further hospitalizations for RHF.
KW - Isolated tricuspid valve surgery
KW - Tricuspid regurgitation
KW - Tricuspid valve disease
KW - Tricuspid repair
KW - Tricuspid replacement
KW - REGURGITATION
KW - IMPACT
U2 - 10.1093/ejcts/ezac172
DO - 10.1093/ejcts/ezac172
M3 - Article
C2 - 35266511
SN - 1010-7940
VL - 62
JO - European Journal of Cardio-Thoracic Surgery
JF - European Journal of Cardio-Thoracic Surgery
IS - 2
ER -