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Background: Isolated tricuspid valve (TV) surgery is rarely performed, however recognition of the adverse effects of untreated TV regurgitation have created growing interest in invasive therapies. There is limited data comparing outcomes for TV repair versus replacement. We sought to compare surgical outcomes using the largest United States all-payer database.
Methods: The National Inpatient Sample was used to identify patients >18 years who underwent isolated TV repair or TV replacement (TVR) from 2004-2013. Results were weighted to represent national averages. Patients with congenital heart disease, endocarditis, and those undergoing concomitant cardiac surgeries except coronary bypass were excluded. The primary outcome was hospital mortality. Secondary outcomes included stroke, pacemaker implantation, and blood transfusion.
Results: 5005 patients underwent isolated TV surgery, including TV repair (40.3%), mechanical TVR (23.2 %), and bioprosthetic TVR (35.9 %). Patient characteristics and in-patient outcomes are in Table 1. Isolated TV surgery carries an 8.8% mortality. After adjusting for age, sex, and comorbidities, mortality for TVR was significantly higher than TV repair (odds ratio 2.20, p=0.002).
Conclusions: Isolated TV surgery carries a significant in-hospital mortality risk. TV repair results in significantly lower mortality, pacemaker implantation and blood transfusion. These findings suggest that when appropriate TV repair is the preferable surgical approach.
Room 204 A
Sunday, March 19, 2017, 9:17 a.m.-9:27 a.m.
Session Title: Highlighted Original Research: Valvular Heart Disease and the Year in Review
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 912-14
- 2017 American College of Cardiology Foundation