Predictors of late outcomes after concomitant tricuspid valve repair with left-sided valve surgery

Kazuki Noda ¹, Naonori Kawamoto ², Satoshi Kainuma ¹

⁰Departments of Cardiac Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan.

General Thoracic and Cardiovascular Surgery +

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April 22, 2024

View abstract on PubMed

Summary

Concomitant tricuspid valve (TV) repair alongside left-sided valve surgery offers good long-term survival and durability, preventing recurrent tricuspid regurgitation (TR). Preoperative patient health significantly impacts outcomes for those with severe TR.

Area Of Science

Cardiovascular Surgery
Cardiac Valve Repair
Surgical Outcomes

Background

Concomitant tricuspid valve (TV) repair is performed during left-sided valve surgery to prevent tricuspid regurgitation (TR).
Limited data exists on the long-term efficacy and predictors of recurrence for TV repair.
This study evaluates late outcomes and identifies mortality/TR recurrence predictors.

Purpose Of The Study

To assess the long-term survival and durability of concomitant TV repair.
To identify predictors of mortality and recurrent TR after TV repair in patients undergoing left-sided valve surgery.

Main Methods

Retrospective analysis of 645 patients undergoing concomitant TV repair and left-sided valve surgery (2006-2020).
Evaluation of in-hospital/30-day mortality, long-term survival, and freedom from recurrent TR (grade ≥3).
Multivariate analysis to determine predictors of mortality and recurrent TR.

Main Results

Long-term survival was 90.3% at 5 years and 80.8% at 10 years.
Freedom from recurrent TR was 96.1% at 5 years and 88.8% at 10 years.
Predictors of mortality in severe TR included prior pacemaker, renal dysfunction, diabetes, and NYHA class ≥3. Annuloplasty type did not predict recurrent TR.

Conclusions

Concomitant TV repair demonstrates acceptable long-term survival and TR durability.
Preoperative patient factors significantly influence prognosis, particularly in those with severe TR.

Keywords:

Concomitant tricuspid valve annuloplasty Predictors of mortality Predictors of recurrent TR