Thomas M. Bashore
Tricuspid valve surgery is not often performed on patients, although utilization has increased during a 10-year period, according to a study published in the Journal of the American College of Cardiology.
Operative mortality was unchanged during the study period, with most deaths occurring in patients who underwent tricuspid valve replacement.
Chad J. Zack, MD, a cardiology fellow at Mayo Clinic in Rochester, Minnesota, and colleagues analyzed data from the National Inpatient Sample from 2004 to 2013 of patients who underwent tricuspid valve repair or replacement without simultaneous mitral, aortic or pulmonary valve surgery. Patients who had active endocarditis or congenital heart disease were excluded.
The outcomes of interest were the type of surgery, number of procedures performed annually, postoperative morbidity, in-hospital mortality, length of hospital stay, total cost of hospitalization and discharge destination.
During the study period, 5,005 admissions (median age, 62 years; 58% women) occurred for isolated tricuspid valve surgery. The number of isolated tricuspid valve surgeries increased from 290 procedures in 2004 to 780 procedures in 2013 (P < .001).
The in-hospital mortality for isolated tricuspid valve surgery of 8.8% was consistent throughout the study period. Adjusted in-hospital mortality was higher in patients who underwent tricuspid valve replacement vs. tricuspid valve repair (OR = 1.91; 95% CI, 1.18-3.08).
“This study fills an important gap in the published data by addressing the national prevalence of [tricuspid valve] surgery, defining operative mortality and assessing mortality by valve repair or replacement,” Zack and colleagues wrote.
“Further investigation into this puzzling patient population is critical, as numerous percutaneous treatment strategies for [tricuspid regurgitation] are in development, and careful patient selection will be mandatory as they make their way into clinical practice,” Thomas M. Bashore, MD, professor of medicine at Duke University School of Medicine and Cardiology Today Editorial Board Member, and John D. Serfas, MD, trainee at Duke University Medical Center, wrote in a related editorial. “The authors have conducted a timely first exploration into outcomes after tricuspid surgery in these patients, and thus have provided an important foundation for further research.” – by Darlene Dobkowski
Zack, Bashore and Serfas report no relevant financial disclosures.