Isolated Tricuspid Valve Surgery: Repair Versus Replacement

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Surgical Outcomes Research

Background:

• Isolated tricuspid valve surgery (ITVS) is a rare procedure with limited published data.
• This study investigates outcomes of ITVS, comparing valve repair (TVR) versus valve replacement (TVRep).

Purpose of the Study:

• To compare surgical outcomes and mortality rates between TVR and TVRep in patients undergoing ITVS.
• To identify factors influencing outcomes in ITVS procedures.

Main Methods:

• Retrospective analysis of 34 patients who underwent ITVS between 2008 and 2017.
• Patients were divided into TVR (n=20) and TVRep (n=14) groups.
• Preoperative characteristics, operative data, outcomes, and mortality were analyzed.

Main Results:

• TVR was the preferred approach (58.8%). Patients undergoing TVRep had higher rates of previous cardiac surgery and higher logistic EuroSCORE.
• TVRep was associated with longer surgery, ICU stay, hospital stay, and increased need for ventilation and inotropic support.
• While 30-day mortality was similar, TVRep showed significantly higher 1-year mortality (35.7% vs. 5%).

Conclusions:

• Tricuspid valve repair (TVR) offers better outcomes, fewer complications, and lower mortality compared to tricuspid valve replacement (TVRep).
• These differences persist despite potential complexities in the TVRep group, often involving reoperations.