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Racial and Ethnic Variations in Patients Undergoing Mitral and Tricuspid Valve Surgery
Nolan M Winicki1, Isabella S Florissi1, Salman Zaheer1
1Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
The Journal of Surgical Research
|June 5, 2024
Summary
Race/ethnicity impacts presentation for mitral and tricuspid valve surgery, with non-White patients having more comorbidities. However, adjusted outcomes and repair rates did not differ by race.
Area of Science:
- Cardiovascular Surgery
- Health Disparities
- Epidemiology
Background:
- Conflicting evidence exists regarding race/ethnicity's impact on outcomes after mitral valve (MV) surgery.
- This study investigates the association between race/ethnicity and the presentation and outcomes of patients undergoing MV and tricuspid valve (TV) surgery.
Purpose of the Study:
- To examine the influence of race/ethnicity on preoperative characteristics.
- To assess the impact of race/ethnicity on MV and TV repair rates.
- To determine the association between race/ethnicity and postoperative outcomes.
Main Methods:
- Retrospective analysis of 5984 patients undergoing MV, TV, or both surgeries from 2012 to 2021.
- Assessment of race/ethnicity (White, Black, Hispanic, Asian, mixed/other) in relation to preoperative factors, repair rates, and outcomes.
- Multivariable adjustment to control for confounding variables.
Main Results:
- Black patients exhibited higher predicted surgical risk and more comorbidities compared to White patients.
- Black and Hispanic patients were less likely to undergo elective procedures than White patients.
- While MV disease etiology differed by race/ethnicity (degenerative more common in White, rheumatic in non-White), adjusted repair rates and adverse outcomes, including mortality, were similar across groups.
Conclusions:
- Patient race/ethnicity is linked to differences in comorbidity burden and valvular heart disease etiology at presentation.
- Strategies focusing on early detection and timely referral for valvular heart disease are crucial.
- Despite differing presentations, surgical outcomes for MV and TV procedures appear equitable across racial/ethnic groups after adjustment.
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