Repair or replacement for isolated tricuspid valve pathology? Insights from a surgical analysis on long-term survival

Mina Farag, Rawa Arif, Anton Sabashnikov, Mohamed Zeriouh, Aron Frederik Popov, Arjang Ruhparwar, Bastian Schmack, Pascal M. Dohmen, G. Szabó, Matthias Karck, Alexander Weymann

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Abstract

Background: Long-term follow-up data concerning isolated tricuspid valve pathology after replacement or reconstruction is limited. Current American Heart Association guidelines equally recommend repair and replacement when surgical intervention is indicated. Our aim was to investigate and compare operative mortality and long-term survival in patients undergoing isolated tricuspid valve repair surgery versus replacement. Material/Methods: Between 1995 and 2011, 109 consecutive patients underwent surgical correction of tricuspid valve pathology at our institution for varying structural pathologies. A total of 41 (37.6%) patients underwent tricuspid annuloplasty/repair (TAP) with or without ring implantation, while 68 (62.3%) patients received tricuspid valve replacement (TVR) of whom 36 (53%) were mechanical and 32 (47%) were biological prostheses. Results: Early survival at 30 days after surgery was 97.6% in the TAP group and 91.1% in the TVR group. After 6 months, 89.1% in the TAP group and 87.8% in the TVR group were alive. In terms of long-term survival, there was no further mortality observed after one year post surgery in both groups (Log Rank p=0.919, Breslow p=0.834, Tarone-Ware p=0.880) in the Kaplan-Meier Survival analysis. The 1-, 5-, and 8-year survival rates were 85.8% for TAP and 87.8% for TVR group. Conclusions: Surgical repair of the tricuspid valve does not show survival benefit when compared to replacement. Hence valve replacement should be considered generously in patients with reasonable suspicion that regurgitation after repair will reoccur.

Original languageEnglish
Pages (from-to)1017-1025
Number of pages9
JournalMedical Science Monitor
Volume23
DOIs
Publication statusPublished - Feb 25 2017

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Keywords

  • Cardiac valve annuloplasty
  • Tricuspid valve
  • Tricuspid valve insufficiency

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Farag, M., Arif, R., Sabashnikov, A., Zeriouh, M., Popov, A. F., Ruhparwar, A., Schmack, B., Dohmen, P. M., Szabó, G., Karck, M., & Weymann, A. (2017). Repair or replacement for isolated tricuspid valve pathology? Insights from a surgical analysis on long-term survival. Medical Science Monitor, 23, 1017-1025. https://doi.org/10.12659/MSM.900841