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Surgical outcomes of severe tricuspid regurgitation: predictors of adverse clinical outcomes.
MedLine Citation:
PMID:  23038792     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Although recent studies contributed to an improved understanding of the prognosis of patients undergoing tricuspid valve (TV) surgery, the data are limited to certain causes of tricuspid regurgitation (TR) or types of surgery. OBJECTIVE: This study aimed to identify predictors of clinical outcomes of patients undergoing TV surgery for severe TR of various aetiologies. DESIGN: A retrospective cohort study. SETTING: A single tertiary referral centre. PATIENTS: 449 consecutive patients (152 men, aged 56.2±12. 3 years) who underwent TV surgery (397 repairs and 52 replacements) due to severe TR between 1997 and 2010. MAIN OUTCOME MEASURES: The primary outcome of interest was death from any cause. RESULTS: The early death rate was 4.2% (n=19) and 101 patients died in the late period (median follow-up of 63.3 months; range 0-210.4 months). The 5- and 10-year survival rates were 82.4±1.9% and 71.7±2.8%, respectively. Cox-regression analysis revealed that age (HR=1.03; 95% CI 1.01 to 1.05), male gender (HR=1.96; 95% CI 1.29 to 2.99), New York Heart Association functional class IV (HR=2.08; 95% CI 1.31 to 3.30), presence of liver cirrhosis (HR=2.51; 95% CI 1.11 to 5.68) and preoperative levels of haemoglobin (HR=0.89; 95% CI 0.80 to 0.99), albumin (HR=0.52; 95% CI 0.33 to 0.81) and estimated glomerular filtration rate (HR=0.86; 95% CI 0.78 to 0.95) were independent determinants of mortality. Procedural type (p=0.58) or causes of TR (p=0.97), however, were not predictive of mortality. CONCLUSIONS: Long-term survival after TV surgery for severe TR was affected by several preoperative factors including advanced heart failure symptom, comorbidity, end-organ dysfunction and laboratory abnormalities, but not by the type of surgery or causes of TR.
Authors:
Joon Bum Kim; Sung-Ho Jung; Suk Jung Choo; Cheol Hyun Chung; Jae Won Lee
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-4
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  -     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea.
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