OBJECTIVES: This study aimed at assessing mid-term outcomes of patients undergoing isolated tricuspid valve (TV) surgery based on a preoperative baseline clinical and functional classification.METHODS: All patients treated with isolated TV repair or replacement from March 1997 to May 2020 at a single institution were retrospectively reviewed and assessed for mid-term postoperative outcome according to a novel classification [stages 1-5 related to the absence or presence and extent of right heart failure (RHF)]. Kaplan-Meier survival curves were used to estimate mid-term survival. Competing risk analysis for time to cardiac death and hospitalizations for RHF were also carried out.RESULTS: Among the 172 patients included, 129 (75%) underwent TV replacement and 43 (25%) TV repair. At follow-up (median 4.2 years [2.1-7.5]), there were 23 late deaths. At 5 years, overall survival was 100% in stage 2, 88 +/- 4% in stage 3 and 60 +/- 8% in stages 4-5 (P = 0.298 and P = 0.001, respectively). Cumulative incidence function of cardiac death at 5 years was 0%, 8.6 +/- 3.76% and 13.2 +/- 5% for stages 2, 3 and 4 and 5, respectively. At follow-up, cumulative incidence function of re-hospitalizations for RHF was 0% for stage 2, 20 +/- 5% for stage 3 and 20 +/- 6.7% for stages 4 and 5 (P = 0.118 and P = 0.039, respectively).CONCLUSIONS: Both short- and mid-term outcomes support early referral for surgery in isolated TV disease, with excellent survival at 5 years and no further hospitalizations for RHF.
Mid-term outcomes of isolated tricuspid valve surgery according to preoperative clinical and functional staging / Sala, Alessandra; Lorusso, Roberto; Zancanaro, Edoardo; Carino, Davide; Bargagna, Marta; Bisogno, Arturo; Lapenna, Elisabetta; Ruggeri, Stefania; Meneghin, Roberta; Schiavi, Davide; Buzzatti, Nicola; Denti, Paolo; Monaco, Fabrizio; Agricola, Eustachio; Maisano, Francesco; Alfieri, Ottavio; Castiglioni, Alessandro; De Bonis, Michele. - In: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY. - ISSN 1010-7940. - (2022). [Epub ahead of print] [10.1093/ejcts/ezac172]
Mid-term outcomes of isolated tricuspid valve surgery according to preoperative clinical and functional staging
Sala, Alessandra;Bargagna, Marta;Bisogno, Arturo;Agricola, Eustachio;Maisano, Francesco;Alfieri, Ottavio;Castiglioni, Alessandro;De Bonis, Michele
2022-01-01
Abstract
OBJECTIVES: This study aimed at assessing mid-term outcomes of patients undergoing isolated tricuspid valve (TV) surgery based on a preoperative baseline clinical and functional classification.METHODS: All patients treated with isolated TV repair or replacement from March 1997 to May 2020 at a single institution were retrospectively reviewed and assessed for mid-term postoperative outcome according to a novel classification [stages 1-5 related to the absence or presence and extent of right heart failure (RHF)]. Kaplan-Meier survival curves were used to estimate mid-term survival. Competing risk analysis for time to cardiac death and hospitalizations for RHF were also carried out.RESULTS: Among the 172 patients included, 129 (75%) underwent TV replacement and 43 (25%) TV repair. At follow-up (median 4.2 years [2.1-7.5]), there were 23 late deaths. At 5 years, overall survival was 100% in stage 2, 88 +/- 4% in stage 3 and 60 +/- 8% in stages 4-5 (P = 0.298 and P = 0.001, respectively). Cumulative incidence function of cardiac death at 5 years was 0%, 8.6 +/- 3.76% and 13.2 +/- 5% for stages 2, 3 and 4 and 5, respectively. At follow-up, cumulative incidence function of re-hospitalizations for RHF was 0% for stage 2, 20 +/- 5% for stage 3 and 20 +/- 6.7% for stages 4 and 5 (P = 0.118 and P = 0.039, respectively).CONCLUSIONS: Both short- and mid-term outcomes support early referral for surgery in isolated TV disease, with excellent survival at 5 years and no further hospitalizations for RHF.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
