Late outcomes of valve repair versus replacement in isolated and concomitant tricuspid valve surgery: A nationwide cohort study

Wang Kin Wong, Shao Wei Chen*, An Hsun Chou, Hsiu An Lee, Yu Ting Cheng, Feng Chun Tsai, Kuang Tso Lee, Victor Chien Chia Wu, Chun Li Wang, Shang Hung Chang, Pao Hsien Chu

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

39 Scopus citations

Abstract

BACKGROUND: Surgery for tricuspid valve (TV) diseases is associated with poor prognosis, but few studies have described the long-term outcomes by comparing TV repair and replacement in isolated and concomitant TV surgeries separately. METHODS AND RESULTS: Between 2000 and 2013, adult patients who underwent TV repair or replacement surgeries were identified from the Taiwan National Health Insurance Research Database. Outcomes of interest included all-cause mortality, composite outcome, and readmission attributable to any cause. Inverse probability of treatment weighting was used to reduce confounding effects. A total of 2644 patients with a mean follow-up of 4.9 years were included. Of them, 12.6% and 87.4% underwent isolated and concomitant TV surgery, respectively. The in-hospital mortality rates for isolated and concomitant TV surgery were 8.7% and 8.6%, respectively, whereas all-cause mortality rates were 41.7% and 36.8%, respectively. Compared with TV replacement, TV repair demonstrated significantly lower risks of all-cause mortality (concomitant: hazard ratio [HR], 0.76; 95% CI, 0.59–0.99), composite outcome (isolated: subdistribution HR, 0.55; 95% CI, 0.35–0.89; concomitant: subdistribution HR, 0.63; 95% CI, 0.46–0.86), and readmission (isolated: subdistribution HR, 0.64; 95% CI, 0.46–0.91; concomitant: subdistribution HR, 0.72; 95% CI, 0.60–0.86), except insignificant difference in all-cause mortality in isolated surgery. CONCLUSIONS: Compared with replacement, TV repair is associated with better short-and long-term outcomes in both isolated and concomitant TV surgery. However, further prospective clinical trials are warranted.

Original languageEnglish
Article numbere015637
JournalJournal of the American Heart Association
Volume9
Issue number8
DOIs
StatePublished - 21 04 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020, American Heart Association Inc.. All rights reserved.

Keywords

  • Tricuspid valve disease
  • Tricuspid valve repair
  • Tricuspid valve replacement
  • Tricuspid valve surgery

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