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Published on: February 11, 2022
Outcomes of isolated tricuspid valve surgery in contemporary practice
Thomas Weiss1, Peter Ryom Villadsen1, Jesper Khedri Jensen2
1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.
Objectives:
Isolated tricuspid valve (TV) surgery is rarely performed and has been associated with high mortality and morbidity. The aim of this study was to describe the clinical outcome and functional capacity following isolated TV surgery in contemporary practice.
Methods:
We conducted a retrospective cohort study including all patients who underwent isolated TV surgery at our institution from 2013 to 2019. Our cohort was identified using the Western Denmark Heart Registry. Postoperative outcomes were evaluated using patients' medical records. The clinical and echocardiographic status was reported for patients who survived beyond 1 year.
Results:
We included 43 patients [mean age 65.2 ± 13.8, median European System for Cardiac Operative Risk Evaluation II 1.8 (interquartile range 2.0)]. Twelve (27.9%) had prior cardiac surgery. Up to 90-day follow-up, no patient died and major morbidity was limited to 4 patients (9.3%) requiring pacemaker implantation and 1 patient requiring 2 reoperations. Within 1 year, 4 patients (9.3%) died. Nine patients (20.1%) required single readmission for cardiac reasons during the median follow-up of 38.4 months (interquartile range 30.9 months). All patients who survived beyond 1 year (n = 39) completed clinical follow-up. At follow-up, 38/39 (97.4%) patients were New York Heart Association I or II compared to 12/39 (30.8%) preoperatively (P = 0.001). The presence of oedema and intensity of diuretic treatment were significantly reduced (P = 0.005 and P = 0.008, respectively). Echocardiographic follow-up showed significant improvement of TV dysfunction in all patients.
Conclusions:
Our results suggest that isolated TV surgery can be performed safely and greatly improve patients' functional status. Our findings support the importance of optimal surgical timing and patient selection.
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