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DOI: 10.1055/s-0041-1725763
Predictor for Operative Risk in Patients with Reoperative Isolated Tricuspid Valve Surgery
Objectives: Reoperative isolated tricuspid valve (TV) surgery is considered as a high risk procedure. The purpose of this study was to evaluate risk factors for mortality after redo TV-surgery.
Methods: From January 2005 to January 2019, a total of 98 patients with isolated TV regurgitation and prior cardiac surgery were referred to our institution for TV operation. The mean age of the patients was 66.0 ± 10.9 years, 61 patients (62.2%) were female. We retrospectively analyzed the clinical outcome with a focus on the preoperative parameters to evaluate the operative risk. Mean follow-up was 4.97 ± 4.1 years.
Result: Preoperative NYHA was in average 2.9, left ventricular ejection fraction 52.5 ± 10.9%, systolic pulmonal artery pressure 38.3 ± 13.0 mm Hg, creatinine 115.4 ± 66.6 μmol/L, bilirubin 20.0 ± 19.6 μmol/L, INR 1.5 ± 0.9, mean MELD-XI Score (Model of End-stage-Liver Disease excluding INR) was 13.3 ± 4.0 μmol/L. Thirty-day mortality was 5.1%, 5-year survival was 59.4 ± 5.4%. Cox regression analysis evaluated the MELD-XI-Score as a highly significant predictor for postoperative mortality (odds ratio: 1.1, CI 95% 1.1–1.2; p < 0.001), while left ventricular function, systolic pulmonary artery pressure, gender and age weren`t.
Conclusion: Hepatorenal dysfunction was the main factor for limited postoperative survival in our patient cohort. The MELD XI score seems to be a reliable score, which is easy to determine and which can predict the perioperative risk in patients with prior cardiac surgery and indication for TV surgery.
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Die Autoren geben an, dass kein Interessenkonflikt besteht.
Publikationsverlauf
Artikel online veröffentlicht:
19. Februar 2021
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