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Thorac Cardiovasc Surg
DOI: 10.1055/a-2300-6791
Original Cardiovascular

Isolated Tricuspid Valve Surgery for Functional Tricuspid Regurgitation

Daisuke Kaneyuki 
1   Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Andrew M. Jordan
1   Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Jake L. Rosen
1   Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Thomas Reese Macmillan
1   Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Rohinton J. Morris
1   Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
,
Vakhtang Tchantchaleishvili
1   Division of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States
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Abstract

Background Severe tricuspid regurgitation (TR) adversely affects long-term survival; however, isolated tricuspid valve (TV) surgery has been rarely performed due to high operative mortality. In addition, the previous literature included heterogeneous TR etiologies. Therefore, we aimed to elucidate early and long-term outcomes of isolated TV surgery for functional TR.

Methods An electronic search was performed to identify all relevant studies. Baseline characteristics, perioperative variables, and clinical outcomes were extracted and pooled for meta-analysis.

Results This meta-analysis included seven studies. Pooled analyses showed that 68% (35, 89) of patients had preoperative atrial fibrillation or flutter, and 58% (11, 94) had a history of left-sided valve surgery. Seventy-three percent (65, 80) of patients had at least one physical exam finding of right-sided heart failure, and 57% (44, 69) were in New York Heart Association class III or IV. TV replacement was more common than repair. In TV replacement, bioprosthetic valve (39%, 13, 74) was more common than mechanical prosthesis (22%, 18, 26). The early mortality rate was 7%. Twenty percent of patients required a permanent pacemaker postoperatively. The overall 1- and 5-year survival rates were 84.5 and 69.1%, respectively.

Conclusion More than half of the patients who underwent isolated TV surgery for functional TR had undergone left-sided valve surgery and had significant heart failure symptoms at the time of surgery. Further studies on the surgical indication for concomitant TV surgery at the time of left-sided valve surgery and the appropriate timing of surgery for isolated functional TR are needed to improve survival.

Keywords

cardiac - heart valve surgery - tricuspid valve

Supplementary Material



Publication History

Received: 29 December 2023

Accepted: 03 April 2024

Accepted Manuscript online:
05 April 2024

Article published online:
03 May 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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