PMID- 29589379
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20181211
IS  - 1897-4279 (Electronic)
IS  - 0022-9032 (Linking)
VI  - 76
IP  - 4
DP  - 2018
TI  - Results and factors associated with adverse outcome after tricuspid valve 
      replacement.
PG  - 731-739
LID - 10.5603/KP.a2018.0026 [doi]
AB  - BACKGROUND AND AIM: This retrospective analysis of patients with severe tricuspid 
      valve disease, who underwent tricuspid valve replacement (TVR) for either 
      tricuspid regurgitation or stenosis, has been designed to determine the factors 
      that predict poor hospital and long-term survival. METHODS: The study population 
      comprised 86 patients, 65 women and 21 men, who underwent TVR with or without 
      con-comitant surgical procedures between 2000 and 2010 at our institution. 
      Patients with Ebstein's or other complex congenital anomalies were excluded from 
      the study. RESULTS: Average age at operation was 58.5 +/- 12.5 (range 16-78) years. 
      Fifty (58.1%) patients had undergone previous cardiac surgery. Forty-two patients 
      were in New York Heart Association (NYHA) class III functional capacity, and 18 
      were in class IV. Symptoms of right heart failure (HF) were present in 66 
      patients, of whom 19 had ascites. Bioprosthetic tricuspid valves were implanted 
      in 84 patients and mechanical prostheses in two. The choice to proceed to TVR 
      instead of repair was individualised and based on the surgeon's preference. 
      In-hospital mortality was 18 (20.9%) patients, caused mainly by multi-organ and 
      HF, and was significantly related to NYHA class and symptoms of right HF before 
      surgery, with no mortality in patients with NYHA class I and II, 19% mortality 
      with NYHA class III, and 55.6% mortality with NYHA class IV. Eighteen (20.9%) 
      patients died during postoperative follow-up. The main risk factors associated 
      with perioperative mortality were: the presence of severe symptoms at the time of 
      surgery, low preoperative haematocrit, postoperative complications, postoperative 
      ventilation time longer than 72 h, and renal failure requiring dialysis. Elevated 
      pulmonary artery pressure, preoperative symptoms of right HF, and low haematocrit 
      unfavourably affected the long-term results. CONCLUSIONS: Many earlier studies 
      reported high mortality and morbidity after TVR in both early and late 
      postoperative peri-ods. Our main finding is that good outcomes for TVR are 
      achievable in properly selected patients. Sixty of 86 patients in our group had 
      preoperative NYHA functional class III and IV, which suggests that surgical 
      timing was late in many patients. Based on our observations, we propose that 
      surgical correction of severe tricuspid valve disease should be considered before 
      the development of advanced HF, when patients are asymptomatic or only 
      oligosymptomatic.
FAU - Litwinski, Pawel
AU  - Litwinski P
AD  - The Cardinal Stefan Wyszynski Institute of Cardiology, Alpejska 42 St., 04-628 
      Warsaw-Anin, Poland. open4cor@gmail.com.
FAU - Kolsut, Piotr
AU  - Kolsut P
FAU - Sitko, Tadeusz
AU  - Sitko T
FAU - Zielinski, Tomasz
AU  - Zielinski T
FAU - Hoffman, Piotr
AU  - Hoffman P
FAU - Hryniewiecki, Tomasz
AU  - Hryniewiecki T
FAU - Rozanski, Jacek
AU  - Rozanski J
FAU - Kusmierczyk, Mariusz
AU  - Kusmierczyk M
LA  - eng
PT  - Journal Article
DEP - 20180328
PL  - Poland
TA  - Kardiol Pol
JT  - Kardiologia polska
JID - 0376352
SB  - IM
CIN - Kardiol Pol. 2018;76(4):709-710. PMID: 29652419
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Prosthesis Implantation/*adverse effects/methods/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/*epidemiology/etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Tricuspid Valve/*surgery
OTO - NOTNLM
OT  - cardiac surgery
OT  - outcomes
OT  - tricuspid valve
EDAT- 2018/03/29 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/03/29 06:00
PHST- 2017/07/09 00:00 [received]
PHST- 2017/12/27 00:00 [accepted]
PHST- 2017/10/22 00:00 [revised]
PHST- 2018/03/29 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/03/29 06:00 [entrez]
AID - VM/OJS/KP/11476 [pii]
AID - 10.5603/KP.a2018.0026 [doi]
PST - ppublish
SO  - Kardiol Pol. 2018;76(4):731-739. doi: 10.5603/KP.a2018.0026. Epub 2018 Mar 28.