Author + information
- Received May 26, 2017
- Revision received October 9, 2017
- Accepted October 17, 2017
- Published online December 11, 2017.
- Chad J. Zack, MDa,
- Erin A. Fender, MDa,
- Pranav Chandrashekar, MBBSa,
- Yogesh N.V. Reddy, MBBSa,
- Courtney E. Bennett, DOa,b,
- John M. Stulak, MDc,
- Virginia M. Miller, PhDc,d and
- Rick A. Nishimura, MDa,∗ ()
- aDepartment of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota
- bDepartment of Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
- cDepartment of Surgery, Mayo Clinic, Rochester, Minnesota
- dDepartment of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- ↵∗Address for correspondence:
Dr. Rick A. Nishimura, Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905.
Background Severe isolated disease of the tricuspid valve (TV) is increasing and results in intractable right heart failure. However, isolated TV surgery is rarely performed, and there are little data describing surgical outcomes.
Objectives The purpose of this study was to evaluate contemporary utilization trends and in-hospital outcomes for isolated TV surgery in the United States.
Methods Patients age >18 years who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients with congenital heart disease, with endocarditis, and undergoing concomitant cardiac operations except for coronary bypass surgery were excluded.
Results Over a 10-year period, a total of 5,005 isolated TV operations were performed nationally. Operations per year increased from 290 in 2004 to 780 in 2013 (p < 0.001 for trend). In-hospital mortality was 8.8% and did not vary across the study period. Adjusted in-hospital mortality for TV replacement was significantly higher than TV repair (odds ratio: 1.91; 95% confidence interval: 1.18 to 3.09; p = 0.009).
Conclusions Isolated TV surgery is rarely performed, although utilization has increased over time. However, despite an increase in surgical volume, operative mortality has not changed. Mortality is greatest in patients undergoing valve replacement. Given the increasing prevalence of isolated TV disease in the population, research into optimal surgical timing and patient selection is critical.
- isolated tricuspid valve disease
- national inpatient sample
- tricuspid regurgitation
- tricuspid valve repair
- tricuspid valve replacement
This publication was made possible by funding from the National Institutes of Health CTSA grant number UL1 TR000135 from the National Center for Advancing Translational Sciences and grant number P50 AG044170 (to Dr. Miller). The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official view of the National Institutes of Health. The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Zack and Fender contributed equally to this work and are joint first authors.
- Received May 26, 2017.
- Revision received October 9, 2017.
- Accepted October 17, 2017.
- 2017 American College of Cardiology Foundation
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