Survival of Tricuspid Valve Replacement in Patients With Previous Tricuspid Valve Surgery

This study was performed to investigate the short-term and long-term survival of patients who underwent reoperative tricuspid valve replacement (TVR).

A retrospective analysis was performed of 273 patients who underwent TVRs while hospitalised in Beijing Anzhen Hospital from November 1993 to August 2018. Fifty-six (56) of them underwent reoperative TVR: 36 had previous tricuspid valve repair and 20 had previous TVR. Follow-up was 100% complete, with a mean follow-up of 8 years (range, 1-15 years).

The overall in-hospital mortality was 17.9% (n=10). In the univariate analysis, the overall in-hospital mortality and renal failure rate in the replacement group were lower than those in the repair group (5.0% vs 25%; p=0.046 and 27.8% vs 5%; p=0.040). However, in-hospital mortality was no longer statistically significant after multivariate adjustment (adjusted OR 0.318; 95% CI 0.030-3.338; p=0.340). There was no significant difference in survival between the patients with previous repair and those with previous replacement (log-rank test, p=0.839). Factors that correlated with long-term mortality on multivariate analysis were age >60 years (adjusted HR 11.753; 95% CI 1.686-81.915; p=0.013); cardiopulmonary bypass time (adjusted HR 1.019; 95% CI 1.005-1.034; p=0.009); intensive care unit time (adjusted HR 1.024; 95% CI 1.006-1.042; p=0.009); and ventilation time (adjusted HR 0.982; 95% CI 0.965-0.998; p=0.030).

Reoperative TVR was associated with high in-hospital mortality and morbidity. Overall in-hospital mortality was similar between the previous replacement group and the previous repair group. Previous tricuspid valve repair and replacement had similar long-term survival.