TY - JOUR
T1 - National Trends and Outcomes in Isolated Tricuspid Valve Surgery
AU - Zack, Chad J.
AU - Fender, Erin A.
AU - Chandrashekar, Pranav
AU - Reddy, Yogesh N.V.
AU - Bennett, Courtney E.
AU - Stulak, John M.
AU - Miller, Virginia M.
AU - Nishimura, Rick A.
N1 - Publisher Copyright:
© 2017 American College of Cardiology Foundation
PY - 2017/12/19
Y1 - 2017/12/19
N2 - Background Severe isolated disease of the tricuspid valve (TV) is increasing and results in intractable right heart failure. However, isolated TV surgery is rarely performed, and there are little data describing surgical outcomes. Objectives The purpose of this study was to evaluate contemporary utilization trends and in-hospital outcomes for isolated TV surgery in the United States. Methods Patients age >18 years who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients with congenital heart disease, with endocarditis, and undergoing concomitant cardiac operations except for coronary bypass surgery were excluded. Results Over a 10-year period, a total of 5,005 isolated TV operations were performed nationally. Operations per year increased from 290 in 2004 to 780 in 2013 (p < 0.001 for trend). In-hospital mortality was 8.8% and did not vary across the study period. Adjusted in-hospital mortality for TV replacement was significantly higher than TV repair (odds ratio: 1.91; 95% confidence interval: 1.18 to 3.09; p = 0.009). Conclusions Isolated TV surgery is rarely performed, although utilization has increased over time. However, despite an increase in surgical volume, operative mortality has not changed. Mortality is greatest in patients undergoing valve replacement. Given the increasing prevalence of isolated TV disease in the population, research into optimal surgical timing and patient selection is critical.
AB - Background Severe isolated disease of the tricuspid valve (TV) is increasing and results in intractable right heart failure. However, isolated TV surgery is rarely performed, and there are little data describing surgical outcomes. Objectives The purpose of this study was to evaluate contemporary utilization trends and in-hospital outcomes for isolated TV surgery in the United States. Methods Patients age >18 years who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients with congenital heart disease, with endocarditis, and undergoing concomitant cardiac operations except for coronary bypass surgery were excluded. Results Over a 10-year period, a total of 5,005 isolated TV operations were performed nationally. Operations per year increased from 290 in 2004 to 780 in 2013 (p < 0.001 for trend). In-hospital mortality was 8.8% and did not vary across the study period. Adjusted in-hospital mortality for TV replacement was significantly higher than TV repair (odds ratio: 1.91; 95% confidence interval: 1.18 to 3.09; p = 0.009). Conclusions Isolated TV surgery is rarely performed, although utilization has increased over time. However, despite an increase in surgical volume, operative mortality has not changed. Mortality is greatest in patients undergoing valve replacement. Given the increasing prevalence of isolated TV disease in the population, research into optimal surgical timing and patient selection is critical.
KW - isolated tricuspid valve disease
KW - national inpatient sample
KW - tricuspid regurgitation
KW - tricuspid valve repair
KW - tricuspid valve replacement
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U2 - 10.1016/j.jacc.2017.10.039
DO - 10.1016/j.jacc.2017.10.039
M3 - Article
C2 - 29241483
AN - SCOPUS:85037341991
SN - 0735-1097
VL - 70
SP - 2953
EP - 2960
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 24
ER -