Document Detail


Surgical risk and outcome of repair versus replacement for late tricuspid regurgitation in redo operation.
MedLine Citation:
PMID:  22364972     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Late tricuspid regurgitation after previous cardiac operation remains controversial in terms of when to repair and who will benefit. We reviewed our surgical experiences and stratified the risk factors for death and morbidity.
METHODS: From September 2005 to September 2010, 77 consecutive patients (36 men [47%]) underwent redo open heart operations with the tricuspid valve (TV) procedure. Their mean age was 56 ± 13 years (range, 27 to 83 years). TV repair was performed in 44 (57%) and TV replacement in 33 (43%): 23 received bioprostheses; 10 received mechanical prostheses.
RESULTS: Fourteen (18%) patients died after the operation. Risk factors of hospital death by multivariate analysis were age (>65 years), preoperative renal insufficiency (creatinine >2 mg/dL), and preoperative severe liver cirrhosis (Child classification C). Compared with the group that underwent TV repair, those who underwent TV replacement tended to have had previous TV operations (46% vs 9%; p < 0.001) and preoperative Child class C liver cirrhosis (21% vs 2%; p = 0.018). Although in-hospital mortality was insignificant (24% vs 14%; p = 0.232), postoperative morbidities of tracheotomy, gastrointestinal bleeding, and late death were higher in the replacement group.
CONCLUSIONS: Patients who had previous TV operations and preoperative severe liver cirrhosis were more likely to undergo TV replacement in tricuspid reoperations. Compared with patients in the repair group, patients in the replacement group had higher morbidities and low late survival. Earlier intervention, before decompensated heart failure occurs, is warranted to improve the outcome.
Authors:
Shao-Wei Chen; Feng-Chun Tsai; Feng-Chang Tsai; Yin-Kai Chao; Yao-Kuang Huang; Jaw-Ji Chu; Pyng-Jing Lin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  93     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  770-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
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