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Five-year outcomes of tricuspid valve repair versus replacement; a propensity score-matched analysis

Five-year outcomes of tricuspid valve repair versus replacement; a propensity score-matched analysis BackgroundTricuspid valve repair (TVr) is the recommended approach for managing tricuspid regurgitation; however, there is a concern about the long-term durability of the repair. Therefore, this study aimed to compare the long-term outcomes of TVr versus tricuspid valve replacement (TVR) in a matched cohort of patients.MethodsThis study included 1161 patients who underwent tricuspid valve (TV) surgery from 2009 to 2020. Patients were grouped according to the procedure into two groups: patients who underwent TVr (n = 1020) and patients who underwent TVR (n = 159). The propensity score identified 135 matched pairs.ResultsRenal replacement therapy and bleeding were significantly higher in the TVR group compared to the TVr group both before and after matching. Thirty-day mortality occurred in 38 (3.79%) patients in TVr group versus 3 (1.89%) in the TVR group (P ≤ 0.001) but was not significant after matching. After matching, TV reintervention (hazard ratio (HR): 21.44 (95% CI: 2.17–211.95); P  =  0.009) and heart failure rehospitalization (HR: 1.89 (95% CI: 1.13–3.16); P  =  0.015) were significantly higher in the TVR group. There was no difference in mortality in the matched cohort (HR: 1.63 (95% CI: 0.72–3.70); P  =  0.25).ConclusionsTVr was associated with lower renal impairment, reintervention, and heart failure rehospitalization than replacement. TVr remains the preferred approach whenever feasible. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Asian Cardiovascular and Thoracic Annals SAGE

Five-year outcomes of tricuspid valve repair versus replacement; a propensity score-matched analysis

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References (27)

Publisher
SAGE
Copyright
© The Author(s) 2023
ISSN
0218-4923
eISSN
1816-5370
DOI
10.1177/02184923231176508
Publisher site
See Article on Publisher Site

Abstract

BackgroundTricuspid valve repair (TVr) is the recommended approach for managing tricuspid regurgitation; however, there is a concern about the long-term durability of the repair. Therefore, this study aimed to compare the long-term outcomes of TVr versus tricuspid valve replacement (TVR) in a matched cohort of patients.MethodsThis study included 1161 patients who underwent tricuspid valve (TV) surgery from 2009 to 2020. Patients were grouped according to the procedure into two groups: patients who underwent TVr (n = 1020) and patients who underwent TVR (n = 159). The propensity score identified 135 matched pairs.ResultsRenal replacement therapy and bleeding were significantly higher in the TVR group compared to the TVr group both before and after matching. Thirty-day mortality occurred in 38 (3.79%) patients in TVr group versus 3 (1.89%) in the TVR group (P ≤ 0.001) but was not significant after matching. After matching, TV reintervention (hazard ratio (HR): 21.44 (95% CI: 2.17–211.95); P  =  0.009) and heart failure rehospitalization (HR: 1.89 (95% CI: 1.13–3.16); P  =  0.015) were significantly higher in the TVR group. There was no difference in mortality in the matched cohort (HR: 1.63 (95% CI: 0.72–3.70); P  =  0.25).ConclusionsTVr was associated with lower renal impairment, reintervention, and heart failure rehospitalization than replacement. TVr remains the preferred approach whenever feasible.

Journal

Asian Cardiovascular and Thoracic AnnalsSAGE

Published: Jun 1, 2023

Keywords: Tricuspid valve repair; tricuspid valve replacement; tricuspid valve; reinterventions; heart failure readmission; mortality

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