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Surgical Intervention for Isolated Tricuspid Valve Endocarditis-Refining Patients' Selection
Ali Hage1, Rami Abazid2, Fadi Hage1
1Division of Cardiac Surgery, Department of Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada.
Avicenna Journal of Medicine
|June 23, 2025
Summary
Surgical intervention for isolated tricuspid valve infective endocarditis (TVIE) shows a 34.6% mortality rate. Male sex, intravenous drug use (IVDU), low hemoglobin, and reduced left ventricular ejection fraction (LVEF) predict mortality, suggesting early intervention benefits survival.
Area of Science:
- Cardiology
- Infectious Diseases
- Cardiac Surgery
Background:
- Isolated tricuspid valve infective endocarditis (TVIE) is a serious condition requiring surgical intervention.
- Understanding clinical and imaging factors influencing outcomes is crucial for patient management.
Purpose of the Study:
- To analyze clinical and imaging factors in patients with isolated TVIE undergoing surgery.
- To assess short- and long-term outcomes following surgical intervention for isolated TVIE.
Main Methods:
- Retrospective analysis of 26 patients with definite isolated TVIE who underwent surgery between 2004 and 2019.
- Data collection included demographics, preoperative, and postoperative variables.
- Primary outcomes were mortality and a composite of death, readmission for heart failure, or recurrent endocarditis.
Main Results:
- A total of 29 interventions were performed; 75.8% of TVIE cases were related to Staphylococcus aureus.
- The 5.4-year follow-up revealed a 34.6% mortality rate and 57.7% composite outcome rate.
- Male sex, intravenous drug users (IVDU), lower preoperative hemoglobin, and reduced left ventricular ejection fraction (LVEF) were significant predictors of mortality.
Conclusions:
- Surgical intervention for isolated TVIE carries a significant mortality risk (34.6%).
- Predictors of post-surgical mortality include male sex, IVDU history, anemia, and impaired LV systolic function.
- Early surgical intervention before anemia or LV dysfunction may improve survival outcomes.
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