PMID- 23103002
OWN - NLM
STAT- MEDLINE
DCOM- 20130226
LR  - 20121231
IS  - 1552-6259 (Electronic)
IS  - 0003-4975 (Linking)
VI  - 95
IP  - 1
DP  - 2013 Jan
TI  - The risk and outcomes of reoperative tricuspid valve surgery.
PG  - 119-24
LID - S0003-4975(12)01890-5 [pii]
LID - 10.1016/j.athoracsur.2012.08.058 [doi]
AB  - BACKGROUND: Outcomes after tricuspid valve reoperation have not been published 
      before. This study examines our 32-year experience in this cohort of patients. 
      METHODS: Between May 1979 and January 2011, a total of 68 patients who had 
      previous tricuspid valve surgery (49 repairs and 19 replacements) had 
      reoperations on their tricuspid valves. The median age was 60 years (19 to 75). 
      Redo tricuspid valve pathologies included 18 functional and 50 organic. Follow-up 
      was 100% complete, with a mean follow-up of 87 months (5 to 248). RESULTS: 
      Re-repair of the tricuspid valve was feasible in 26 patients (16 of 18 [89%] 
      functional and 10 of 31 [32%] organic, p < 0.001). In-hospital mortality was 
      13.2%. Factors related to early mortality were nonelective surgery, New York 
      Heart Association (NYHA) functional class III/IV, left ventricle ejection 
      fraction less than 0.40, cardiopulmonary bypass time greater than 136 minutes, 
      and postoperative low cardiac output syndrome (p < 0.05). Postoperative 
      complications included 9 reoperations for bleeding, 11 postoperative low cardiac 
      output syndrome, 5 renal failure requiring dialysis, 3 strokes, and 13 pacemaker 
      implantation. Factors related to late mortality were age greater than 60 years, 
      male sex, ventilation time greater than 24 hours, cardiopulmonary bypass time 
      greater than 136 minutes, and postoperative low cardiac output syndrome (p < 
      0.05). Survivors had 5-, 10-, and 15-year survival rates of 86%, 64%, and 33%, 
      respectively. Functional class improved in hospital survivors; NYHA class I/II 
      80.6% compared with preoperative NYHA class III/IV of 90% (p = 0.001). 
      CONCLUSIONS: Redo tricuspid valve surgery is associated with high operative 
      mortality and morbidity; however, survivors benefited from reasonable survival 
      rates. Re-repair of the tricuspid valve is feasible in the majority of patients 
      with functional tricuspid valve pathology, while the majority of patients with 
      underlying organic pathology required a valve replacement.
CI  - Copyright (c) 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All 
      rights reserved.
FAU - Jeganathan, Reubendra
AU  - Jeganathan R
AD  - Department of Cardiothoracic Surgery, Royal Victoria Hospital, Belfast, Northern 
      Ireland, United Kingdom. reuben.jeganathan@belfasttrust.hscni.net
FAU - Armstrong, Susan
AU  - Armstrong S
FAU - Al-Alao, Bassel
AU  - Al-Alao B
FAU - David, Tirone
AU  - David T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20121025
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
CIN - Ann Thorac Surg. 2013 Jan;95(1):125. PMID: 23272833
MH  - Adult
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/*surgery
MH  - Heart Valve Prosthesis Implantation/*methods/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Morbidity/trends
MH  - Ontario/epidemiology
MH  - Postoperative Complications/*epidemiology
MH  - *Reoperation
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Treatment Outcome
MH  - Tricuspid Valve/*surgery
MH  - Young Adult
EDAT- 2012/10/30 06:00
MHDA- 2013/02/27 06:00
CRDT- 2012/10/30 06:00
PHST- 2012/06/18 00:00 [received]
PHST- 2012/08/21 00:00 [revised]
PHST- 2012/08/24 00:00 [accepted]
PHST- 2012/10/30 06:00 [entrez]
PHST- 2012/10/30 06:00 [pubmed]
PHST- 2013/02/27 06:00 [medline]
AID - S0003-4975(12)01890-5 [pii]
AID - 10.1016/j.athoracsur.2012.08.058 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 2013 Jan;95(1):119-24. doi: 10.1016/j.athoracsur.2012.08.058. 
      Epub 2012 Oct 25.