Mid-term results and risks of isolated tricuspid valve reoperation following left-sided valve surgery.

OBJECTIVES

Tricuspid valve reoperation (TVR) following left-sided valve surgery (LSVS) is a high-risk procedure. This study was conducted to analyse the mid-term results and risks of isolated TVR following LSVS.

METHODS

From May 2007 to December 2016, 91 patients who underwent isolated TVR following LSVS were enrolled in this study.

RESULTS

The patients comprised 23 men and 68 women with a mean age of 57.5 ± 8.0 years (range 33-75 years). The in-hospital mortality rate was 2.2% (2 of 91 patients). Fourteen (15.4%) procedures were performed through a median sternotomy, whereas 77 (84.6%) were performed through a right thoracotomy. One patient underwent tricuspid valve repair, while the others underwent valve replacement including 16 (17.6%) cases involving mechanical valves and 74 (81.3%) involving tissue valves. Eight (9.0%) deaths occurred during the follow-up at 9.21 ± 18.8 months (range 1-108 months), including 5 cardiac deaths. The Kaplan-Meier survival rates at 1 year and 5 years were 97.7% and 90.0%, respectively. Previous aortic and mitral valve replacement [odds ratio (OR) 0.161, P = 0.0015], preoperative central venous pressure (OR 1.202, P = 0.0353), pulmonary artery pressure (OR 1.075, P = 0.0134) and left ventricular end-systolic diameter (OR 1.13, P = 0.0155) were the risk factors for a longer intensive care duration. The valve type had no significant effect on the survival of patients who had undergone valve replacement.

CONCLUSIONS

Isolated TVR is a safe and effective surgery for tricuspid valve lesions following LSVS, and right thoracotomy may be a reasonable choice.