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Heart, Lung and Circulation

Survival of Tricuspid Valve Replacement in Patients With Previous Tricuspid Valve Surgery

  • Kun Hua
    Affiliations
    Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China
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  • Zhan Peng
    Affiliations
    Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China
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  • Xiubin Yang
    Affiliations
    Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China
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  • Bin Mao
    Correspondence
    Corresponding author at: Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, 2# Anzhen Road, Cao Yang District, Beijing 100029, China
    Affiliations
    Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Vessel Disease, Beijing, China
    Search for articles by this author

      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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