Author + information
- Chad J. Zack,
- Pranav Chandrashekar,
- Erin Fender,
- Mohammed Al-Hijji and
- Rick Nishimura
Background: Despite guideline recommendations, surgery for isolated tricuspid valve (TV) disease is rarely performed. Existing series report wide variation in operative mortality, between 2-24%. Safety concerns have created a population with an unmet clinical need. Percutaneous repair could provide an alternative approach, however to understand the role of percutaneous repair we must first define the risks of surgery. Therefore, we sought to assess operative outcomes at the national level using the largest US claims database.
Methods: Patients age >18 who underwent TV repair or replacement from 2004-2013 were identified using the Nationwide Inpatient Sample. Patients with congenital heart disease, endocarditis, and those undergoing concomitant cardiac surgeries except coronary bypass were excluded. Results were weighted to represent national averages.
Results: Over 9 years 5,005 surgeries were performed. Patient characteristics and in-hospital outcomes are in Table 1. Operations per year increased from 290 in 2004 to 780 in 2013 (p<0.001). In hospital mortality was 8.8% and was consistent across all study years. Most surgeries were performed at teaching hospitals (86%), and outcomes did not vary by teaching status.
Conclusions: Isolated TV surgery is rare, but utilization has increased over time. Mortality is unacceptably high which suggests a role for percutaneous approaches. Given the prevalence of TV disease research into improved surgical techniques and patient selection is critical.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Valvular Disease Populations at Risk
Abstract Category: 37. Valvular Heart Disease: Therapy
Presentation Number: 1104-029
- 2017 American College of Cardiology Foundation