Objectives
This study was performed to investigate the short-term and long-term survival of patients
who underwent reoperative tricuspid valve replacement (TVR).
Methods
A retrospective analysis was performed of 273 patients who underwent TVRs while hospitalised
in Beijing Anzhen Hospital from November 1993 to August 2018. Fifty-six (56) of them
underwent reoperative TVR: 36 had previous tricuspid valve repair and 20 had previous
TVR. Follow-up was 100% complete, with a mean follow-up of 8 years (range, 1–15 years).
Results
The overall in-hospital mortality was 17.9% (n=10). In the univariate analysis, the
overall in-hospital mortality and renal failure rate in the replacement group were
lower than those in the repair group (5.0% vs 25%; p=0.046 and 27.8% vs 5%; p=0.040).
However, in-hospital mortality was no longer statistically significant after multivariate
adjustment (adjusted OR 0.318; 95% CI 0.030–3.338; p=0.340). There was no significant
difference in survival between the patients with previous repair and those with previous
replacement (log-rank test, p=0.839). Factors that correlated with long-term mortality
on multivariate analysis were age >60 years (adjusted HR 11.753; 95% CI 1.686–81.915;
p=0.013); cardiopulmonary bypass time (adjusted HR 1.019; 95% CI 1.005–1.034; p=0.009);
intensive care unit time (adjusted HR 1.024; 95% CI 1.006–1.042; p=0.009); and ventilation
time (adjusted HR 0.982; 95% CI 0.965–0.998; p=0.030).
Conclusions
Reoperative TVR was associated with high in-hospital mortality and morbidity. Overall
in-hospital mortality was similar between the previous replacement group and the previous
repair group. Previous tricuspid valve repair and replacement had similar long-term
survival.
Keywords
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Article info
Publication history
Published online: July 28, 2021
Accepted:
June 19,
2021
Received in revised form:
June 8,
2021
Received:
November 15,
2020
Identification
Copyright
© 2021 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
