Isolated Reoperative Tricuspid Valve Surgery: Outcomes and Risk Assessment

Tahir I Mohamed; Omar J Baqal; Abdulaziz A Binzaid; Hussam T AlHennawi; Abdulrahman R Barakeh; Omar M Mrayati; Aly M Alsanei

doi:10.37616/2212-5043.1286

Isolated Reoperative Tricuspid Valve Surgery: Outcomes and Risk Assessment

J Saudi Heart Assoc. 2022 Jan 5;33(4):366-373. doi: 10.37616/2212-5043.1286. eCollection 2021.

Authors

Tahir I Mohamed^{1

2}, Omar J Baqal³, Abdulaziz A Binzaid¹, Hussam T AlHennawi³, Abdulrahman R Barakeh³, Omar M Mrayati³, Aly M Alsanei¹

Affiliations

¹ King Faisal Specialist Hospital and Research Center-Riyadh, Heart Center Department, Riyadh, Saudi Arabia.
² Wayne State University School of Medicine, Department of Medicine, Detroit, MI, USA.
³ Alfaisal University College of Medicine, Department of Medicine, Riyadh, Saudi Arabia.

Abstract

Objective: To describe patient characteristics and post-operative outcomes, including early and late mortality, defined by death within 30 days and after 30 days post-surgery, respectively, as well as 20-year survival after isolated reoperative tricuspid surgery.

Methods: We retrospectively analyzed 169 patients who underwent isolated reoperative tricuspid valve surgery at our institution (between 1997 and 2000) and describe post-surgical outcomes including intraoperative, early and late mortality. All patients included completed 21 years of follow-up.

Results: The majority of our patients were females 147 (87%) with the mean age of 45.9 ± 12.9 years. The mean body mass index (BMI, kg/m²) was 27.4 ± 6.0. Previous cardiac surgeries included tricuspid valve surgeries in 169 (100%) patients, with bioprosthetic valves, mechanical valves, annual rings and tricuspid repair surgeries utilized in 37 (21.9%), 21 (12.4%), 38 (22.4%) and 73 (43.2%) patients, respectively. The indication for previous tricuspid surgery was rheumatic heart disease in 154 (91.5%) patients.The most common cause of reoperative valvular surgery was tricuspid regurgitation (TR) in 139 (82.2%), with 66% of patients having severe TR. Other reasons for reoperative surgery included tricuspid stenosis 22 (13%) and dehiscence 8 (4.7%). For the redo surgery, 125 (74%) patients underwent Tricuspid Valve Replacement (TVR), 90 (53%) of whom received bioprosthetic valves while 35 (21%) received mechanical valves. Forty-four patients (26%) underwent Tricuspid Valve Repair. Mortality within 30 days of surgery was 11.3% (20 patients) and 11.4% after 30 days, with 20 years survival being about 80%.

Conclusions: Based on our experience, reoperation for failed isolated tricuspid valve replacement or repair was associated with reasonable mortality and good survival rate over long period of time.

Keywords: Mortality; Outcomes; Redo; Reoperative; Risk assessment; Tricuspid surgery.