Mid-term results and risks of isolated tricuspid valve reoperation following left-sided valve surgery. (14th December 2017)

• Record Type: Journal Article
• Authors: Fang, Liang; Li, Wei; Zhang, Wei; Gu, Weili; Zhu, Dan
• Is Part Of: European journal of cardio-thoracic surgery. Volume 53:Number 5(2018)
• Page Start: 1034
• Page End: 1039
• Publication Date: 2017-12-14
• Subjects: Tricuspid valve -- Reoperation -- Right heart failure; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Periodicals; 617.54
• DOI: 10.1093/ejcts/ezx453
• Languages: English
• ISSNs: 1010-7940

Abstract

Abstract: OBJECTIVES: Tricuspid valve reoperation (TVR) following left-sided valve surgery (LSVS) is a high-risk procedure. This study was conducted to analyse the mid-term results and risks of isolated TVR following LSVS. METHODS: From May 2007 to December 2016, 91 patients who underwent isolated TVR following LSVS were enrolled in this study. RESULTS: The patients comprised 23 men and 68 women with a mean age of 57.5 ± 8.0 years (range 33–75 years). The in-hospital mortality rate was 2.2% (2 of 91 patients). Fourteen (15.4%) procedures were performed through a median sternotomy, whereas 77 (84.6%) were performed through a right thoracotomy. One patient underwent tricuspid valve repair, while the others underwent valve replacement including 16 (17.6%) cases involving mechanical valves and 74 (81.3%) involving tissue valves. Eight (9.0%) deaths occurred during the follow-up at 9.21 ± 18.8 months (range 1–108 months), including 5 cardiac deaths. The Kaplan–Meier survival rates at 1 year and 5 years were 97.7% and 90.0%, respectively. Previous aortic and mitral valve replacement [odds ratio (OR) 0.161, P = 0.0015], preoperative central venous pressure (OR 1.202, P = 0.0353), pulmonary artery pressure (OR 1.075, P = 0.0134) and left ventricular end-systolic diameter (OR 1.13, P = 0.0155) were the risk factors for a longer intensive care duration. The valve type had no significant effect on the survival of patients who had undergone valve replacement. CONCLUSIONS: Isolated TVR is a safe and effective surgery for tricuspid valve lesions following LSVS, and right thoracotomy may be a reasonable choice.