Joshua Greenberg1, Nicholas R Teman2, Jonathan W Haft3, Matthew A Romano3, Francis D Pagani3, Keith D Aaronson1, Audrey H Wu4. 1. Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, Michigan. 2. Division of Thoracic and Cardiovascular Surgery, University of Virginia Health System, Charlottesville, Virginia. 3. Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, Michigan. 4. Division of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, Michigan. Electronic address: ahwu@med.umich.edu.
Abstract
BACKGROUND: Tricuspid regurgitation after cardiac transplantation is associated with worse clinical outcomes. This study sought to determine the association of donor tricuspid valve repair (dTVR) with outcomes after cardiac transplantation. METHODS: Patients who underwent cardiac transplantation between January 20, 2002, and December 31, 2016, were included. Multivariable Cox regression modeling was performed to determine the association between dTVR and the composite outcome of death, posttransplant TVR, kidney transplant after cardiac transplant, or chronic dialysis, and included propensity scoring to control for baseline differences in likelihood of undergoing dTVR. RESULTS: The analysis included 330 patients, with 173 (52.4%) undergoing dTVR. dTVR performance varied by surgeon and also increased over time, with 71 (83.5%) performed during January 1, 2011, to November 30, 2013. Transplant year and surgeon were significantly associated with the baseline likelihood of undergoing dTVR. Although fewer composite outcomes occurred in the dTVR vs no dTVR group (39 [22.5%] vs 56 [36.4%], p = 0.006), dTVR was not significantly associated with the composite outcome in multivariable modeling. Lower risk for the composite outcome was associated with greater number of biopsies during the first posttransplant year, whereas higher risk was associated with more high-grade biopsy specimens and higher creatinine. CONCLUSIONS: There was no significant benefit or harm with regards to the composite of death, posttransplant TVR, or dialysis associated with dTVR.
BACKGROUND:Tricuspid regurgitation after cardiac transplantation is associated with worse clinical outcomes. This study sought to determine the association of donor tricuspid valve repair (dTVR) with outcomes after cardiac transplantation. METHODS:Patients who underwent cardiac transplantation between January 20, 2002, and December 31, 2016, were included. Multivariable Cox regression modeling was performed to determine the association between dTVR and the composite outcome of death, posttransplant TVR, kidney transplant after cardiac transplant, or chronic dialysis, and included propensity scoring to control for baseline differences in likelihood of undergoing dTVR. RESULTS: The analysis included 330 patients, with 173 (52.4%) undergoing dTVR. dTVR performance varied by surgeon and also increased over time, with 71 (83.5%) performed during January 1, 2011, to November 30, 2013. Transplant year and surgeon were significantly associated with the baseline likelihood of undergoing dTVR. Although fewer composite outcomes occurred in the dTVR vs no dTVR group (39 [22.5%] vs 56 [36.4%], p = 0.006), dTVR was not significantly associated with the composite outcome in multivariable modeling. Lower risk for the composite outcome was associated with greater number of biopsies during the first posttransplant year, whereas higher risk was associated with more high-grade biopsy specimens and higher creatinine. CONCLUSIONS: There was no significant benefit or harm with regards to the composite of death, posttransplant TVR, or dialysis associated with dTVR.
Authors: Muath Bishawi; Giorgio Zanotti; Linda Shaw; Michael MacKenzie; Anthony Castleberry; Karsten Bartels; Jacob Schroder; Eric Velazquez; Madhav Swaminathan; Joseph Rogers; Carmelo Milano Journal: Ann Thorac Surg Date: 2018-12-05 Impact factor: 4.330
Authors: Khaled D Algarni; Amr A Arafat; Claudio Pragliola; Yahya S Alhebaishi; Latifa A AlFayez; Khaled AlOtaibi; Abeer M Bakhsh; Ahmed A Amro; Adam I Adam Journal: J Saudi Heart Assoc Date: 2020-05-20