Gemma Sánchez-Espín1, Jorge Rodríguez-Capitán2, Juan José Otero Forero3, Víctor Manuel Becerra Muñoz4, Emiliano Andrés Rodríguez Caulo5, Miguel Such-Martínez6, Carlos Porras-Martín7, José Manuel Villaescusa-Catalán8, María José Mataró-López9, Aranta Guzón-Rementería10, José María Melero-Tejedor11, Encarnación Gutiérrez-Carretero12, Manuel Francisco Jiménez Navarro13. 1. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. gemmase@hotmail.com. 2. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. capijorge@hotmail.com. 3. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. grizotero@gmail.com. 4. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. vmbecerra@gmail.com. 5. Servicio de Cirugía Cardiovascular, Hospital Virgen Macarena, Sevilla, Spain. erodriguezcaulo@hotmail.com. 6. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. drsuch@hotmail.com. 7. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. carlosporras@gcvmalaga.com. 8. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. jmvillaescusa92@gmail.com. 9. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. mjmataro@hotmail.com. 10. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. arantza605@gmail.com. 11. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. josemariamelerotejedor@gmail.com. 12. Servicio de Cirugía Cardiovascular, Hospital Virgen del Rocío, Sevilla, Spain, CIBERCV Sevilla, Spain. gutierrezencarnita@gmail.com. 13. Unidad de Gestión Clínica del Corazón, Hospital Virgen de la Victoria de Málaga, Málaga, Spain, Instituto Biosanitario Málaga (IBIMA), CIBERCV Málaga. Universidad de Málaga (UMA), Málaga, Spain. mjimeneznavarro@gmail.com.
Abstract
BACKGROUND: Isolated tricuspid valve surgery is a rarely performed procedure and traditionally is associated with a bad prognosis, although its clinical outcomes still are little known. The aim of this study was to assess the short- and long-term clinical outcomes obtained at our center after isolated tricuspid valve surgery as treatment for severe tricuspid regurgitation. METHODS: This retrospective study included 71 consecutive patients with severe tricuspid regurgitation who underwent isolated tricuspid valve surgery between December 1996 and December 2017. Perioperative and long-term mortality, tricuspid valve reoperation, and functional class were analyzed after follow up. RESULTS: Regarding surgery, 7% of patients received a De Vega annuloplasty, 14.1% an annuloplasty ring, 11.3% a mechanical prosthesis, and 67.6% a biological prosthesis. Perioperative mortality was 12.7% and no variable was shown to be predictive of this event. After a median follow up of 45.5 months, long-term mortality was 36.6%, and the multivariate analysis identified atrial fibrillation as the only predictor (Hazard Ratio 3.014, 95% confidence interval 1.06-8.566; P = 0.038). At the end of follow up, 63.6% of survivors had functional class I. CONCLUSIONS: Isolated tricuspid valve surgery was infrequent in our center. Perioperative mortality was high, as was long-term mortality. However, a high percentage of survivors were barely symptomatic after follow up.
BACKGROUND: Isolated tricuspid valve surgery is a rarely performed procedure and traditionally is associated with a bad prognosis, although its clinical outcomes still are little known. The aim of this study was to assess the short- and long-term clinical outcomes obtained at our center after isolated tricuspid valve surgery as treatment for severe tricuspid regurgitation. METHODS: This retrospective study included 71 consecutive patients with severe tricuspid regurgitation who underwent isolated tricuspid valve surgery between December 1996 and December 2017. Perioperative and long-term mortality, tricuspid valve reoperation, and functional class were analyzed after follow up. RESULTS: Regarding surgery, 7% of patients received a De Vega annuloplasty, 14.1% an annuloplasty ring, 11.3% a mechanical prosthesis, and 67.6% a biological prosthesis. Perioperative mortality was 12.7% and no variable was shown to be predictive of this event. After a median follow up of 45.5 months, long-term mortality was 36.6%, and the multivariate analysis identified atrial fibrillation as the only predictor (Hazard Ratio 3.014, 95% confidence interval 1.06-8.566; P = 0.038). At the end of follow up, 63.6% of survivors had functional class I. CONCLUSIONS: Isolated tricuspid valve surgery was infrequent in our center. Perioperative mortality was high, as was long-term mortality. However, a high percentage of survivors were barely symptomatic after follow up.