Short- and long-term outcomes of surgery for severe tricuspid regurgitation.
OBJECTIVE
There is little data available for Spain on the outcomes of surgical treatment for severe tricuspid regurgitation. The aim of this study was to analyze clinical and echocardiographic outcomes in a series of patients who received surgical treatment for severe tricuspid regurgitation and to compare outcomes according to the operative approach to valve repair or replacement.


METHODS
Retrospective study in 119 consecutive patients with severe tricuspid regurgitation undergoing valve surgery between April 1996 and February 2010.


RESULTS
A total of 61 ringless and 23 ring annuloplasties were performed and 11 bioprostheses and 24 mechanical prostheses were implanted. Perioperative mortality was 18.5% and was associated with age and cardiopulmonary bypass time. During clinical follow-up (median, 41 [interquartile range, 24-89] months), 2 reoperations were required in the ring annuloplasty and mechanical prosthesis groups; prosthetic thrombosis was diagnosed in 4 patients in the latter group. Total mortality after follow-up was 29.9% and was associated with age>70 years and extracorporeal circulation time. The emergence of new severe tricuspid regurgitation was associated with age and ringless annuloplasty (P=.04).


CONCLUSIONS
Ringless repair was significantly associated with recurrence of severe tricuspid regurgitation. The use of mechanical prostheses was associated with a high rate of thrombosis. No significant differences in perioperative or total mortality were found between the different methods used for repair or valve replacement.
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain. Electronic address: capijorge@hotmail.com.
Jorge
J
Rodríguez-Capitán
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Juan J
JJ
Gómez-Doblas
Unidad de Cardiología, Hospital Costa del Sol, Marbella, Málaga, Spain.
Leticia
L
Fernández-López
Unidad de Medicina Interna, Hospital de Antequera, Antequera, Málaga, Spain.
Raúl
R
López-Salguero
Servicio de Cardiología, Hospital de La Línea, La Línea de la Concepción, Cádiz, Spain.
Manuel
M
Ruiz
Unidad de Medicina Interna, Hospital de La Axarquía, Vélez-Málaga, Málaga, Spain.
Inés
I
Leruite
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Fernando
F
Cabrera-Bueno
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
María J
MJ
Mataró-López
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Gemma
G
Sánchez-Espín
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
José M
JM
Melero-Tejedor
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Carlos
C
Porras-Martín
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Miguel
M
Such
Área del Corazón, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Eduardo
E
de Teresa
D000328:Adult; D000368:Aged; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*
Insuficiencia tricuspídea; Reparación valvular; Sustitución valvular; TR; Tricuspid regurgitation; Valve repair; Valve replacement; tricuspid regurgitation