Isolated Tricuspid Valve Surgery: The Auckland Experience 2011-2019

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Thoracic Surgery

Background:

• Isolated tricuspid valve surgery is historically associated with high morbidity and mortality.
• Many patients previously underwent surgery with severely impaired right ventricular function.
• Referral patterns shifted to encourage earlier intervention before right ventricular remodeling.

Purpose of the Study:

• To assess current outcomes of isolated tricuspid valve surgery.
• To evaluate the impact of early surgical referral on patient results.
• To determine if mortality rates have decreased with current practices.

Main Methods:

• A prospectively maintained hospital database was utilized.
• Identified adult non-congenital patients undergoing standalone tricuspid valve repair or replacement.
• Data collected from July 2011 to July 2019 at New Zealand's largest cardiothoracic unit.

Main Results:

• 50 patients underwent isolated tricuspid valve surgery over 8 years.
• Common indications included functional (40%) and rheumatic (30%) disease.
• Most patients had normal or mildly/moderately impaired preoperative right ventricular function.
• 30-day mortality was 6%, stroke rate was 2%.
• Medium-term survival was 80% at 4 years.

Conclusions:

• Isolated tricuspid valve surgery is no longer a high-mortality operation.
• Outcomes are favorable when performed in patients with preserved right ventricular function.
• Early surgical intervention is key to improving results for severe tricuspid disease.