Long-term outcomes after bioprosthetic tricuspid valve replacement: a multicenter study

Area of Science:

• Cardiovascular Surgery
• Bioprosthetic Valve Research
• Medical Device Outcomes

Background:

• Long-term data on bioprosthetic tricuspid valve replacement (TVR) is limited.
• Understanding outcomes is crucial for patient management and device development.

Purpose of the Study:

• To investigate the long-term clinical outcomes of patients undergoing TVR with bioprostheses.
• To assess survival, reintervention rates, and complications associated with bioprosthetic TVR.

Main Methods:

• Multicentre retrospective study across 10 high-volume centers in 7 countries.
• Included patients undergoing TVR with bioprostheses, analyzing echocardiographic and clinical data.
• Utilized Kaplan-Meier estimates, Cox regression, and competing risk analysis for long-term outcome assessment.

Main Results:

• Of 675 patients, 53% had isolated TVR and 47% had concomitant procedures. Combined procedures showed higher 30-day mortality (14.6% vs 6.74%).
• Cumulative mortality at 5, 10, and 15 years was 27.2%, 46.2%, and 60.6%, respectively.
• Reintervention risk increased significantly after 10 years (23.3% at 15 years). Freedom from reintervention was 56.5% at 15 years.

Conclusions:

• Bioprosthetic TVR is effective for valvular disease but associated with high early and long-term mortality.
• Structural valve degeneration risk significantly rises after 10 years post-implantation.
• Careful patient selection and long-term monitoring are essential for bioprosthetic TVR.