Isolated Tricuspid Valve Surgery. Perioperative Results And Medium-Term Survival

Introduction and objectives: Isolated tricuspid valve surgery (TVS) is an infrequent procedure, and it is considered that it entails a high surgical mortality. The objective is to analyze the medium-term survival, and to determine the variables that impact perioperative and medium-term survival. The predictive accuracy of the usual surgical risk scores was also evaluated.Methods: Unicentric, observational retrospective study, which included all the patients operated on isolated TVS since 2012 to January 2020. Perioperative mortality was analyzed through logistic regression, and long-term survival was analyzed using the Kaplan-Meier survival curves.Results: 51 patients were operated on isolated TVS (18 a nnulopla sties and 33 replacements for prosthetic valves).The study population consisted of a 62.75% of female, with a mean age of 66.07 years (SD 10.57). In the 54% of the cases, the patient was in NYHA functional class of III-IV.Observed in-hospital mortality was 7.8%. The variables with a strongest association with perioperative mortality were a NYHA functional class of III-IV (0% vs 14.3% mortality; p Fisher 0.13) and preoperative anemia (OR: 11.1; CI 95%: 1.04-118.6: p = 0.046).Complete clinical follow-up was achieved in the 94.1% of the study population, with a median followup of 26 months (interquartile interval 12-57 months). Overall survival was 90.1%, 84.3%, 80.2%, 75.2% at 1, 2, 3 and 4 years. In the final follow-up, 75% of the patients were in NYHA functional class I-II.Conclusions: Preoperative NYHA functional class and preoperative anemia are determining factors for early postoperative survival. Medium-term survival and NYHA improvement after isolated TVS are satisfactory. (C) 2021 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cirugia Cardiovascular y Endovascular.