Mid-term outcomes of isolated tricuspid valve surgery according to preoperative clinical and functional staging

A. Sala*, R. Lorusso, E. Zancanaro, D. Carino, M. Bargagna, A. Bisogno, E. Lapenna, S. Ruggeri, R. Meneghin, D. Schiavi, N. Buzzatti, P. Denti, F. Monaco, E. Agricola, F. Maisano, O. Alfieri, A. Castiglioni, M. De Bonis

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.
Original languageEnglish
Number of pages8
JournalEuropean Journal of Cardio-Thoracic Surgery
Issue number2
Early online date10 Mar 2022
Publication statusPublished - 11 Jul 2022


  • Isolated tricuspid valve surgery
  • Tricuspid regurgitation
  • Tricuspid valve disease
  • Tricuspid repair
  • Tricuspid replacement

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