Long-term survival after isolated tricuspid valve replacement

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease

Background:

• Isolated tricuspid valve replacement is a rare procedure.
• The decision for isolated tricuspid valve surgery is challenging.
• This study evaluates outcomes of isolated tricuspid valve replacement without left-sided valve surgery.

Purpose of the Study:

• To review in-hospital mortality and long-term survival after isolated tricuspid valve replacement.
• To identify predictors of poor outcomes in patients undergoing isolated tricuspid valve replacement.

Main Methods:

• Retrospective review of 29 patients undergoing tricuspid valve replacement (1995-2011).
• Exclusion of patients with concomitant mitral or aortic valve surgery.
• Logistic regression analysis to determine predictors of early and late mortality.

Main Results:

• In-hospital mortality was 20.6% (6 deaths).
• Ascites was a significant predictor of in-hospital death (HR 16.96, p=0.0052).
• Higher Frusemide doses predicted late mortality (HR 1.157 per 20mg increase, p=0.0155).
• Ascites and Frusemide dose were associated with overall mortality (p<0.01).
• Estimated 50% survival probability at 12.45 years.

Conclusions:

• Isolated tricuspid valve replacement is associated with high peri-operative risk.
• Long-term survival is comparable to other reports.
• Ascites and elevated Frusemide dosage are linked to adverse outcomes.