title: Beating Heart Versus Arrested Heart Isolated Tricuspid Valve Surgery.
abstract: We analyzed the long-term results of two surgical techniques (beating versus non-beating) for isolated tricuspid valve (TV) surgery.The long-term results of 92 consecutive patients who underwent isolated TV surgery were analyzed. We compared patients with beating heart (BH) surgery (n = 48) with patients undergoing arrested heart (AH) surgery (n = 44).BH surgery was more frequently chosen in urgent/emergent operations (P = 0.029) and in redo-operations (P < 0.001). Preoperatively, the rates of renal insufficiency (P = 0.002) and EuroSCORE (P = 0.019) were higher in the BH group than in the AH group. There were no differences in perioperative outcomes and 30-day mortality between the groups. However, freedom from reoperation was significantly lower in the BH group compared to the AH group (P = 0.039). We observed a trend towards lower survival rates at 1, 5, and 10 years in the BH group (77%, 54%, and 41%) compared to those of the AH group (86%, 75%, and 72%, P = 0.062). Multivariate Cox hazard model analysis revealed preoperative heart rhythm (P = 0.014, odds ratio [OR] = 2.296) and EuroSCORE (P = 0.022, OR = 1.049) as independent risk factors for mortality after isolated TV surgery.The superiority of BH surgery over AG surgery was not proven. Surgical intervention should be considered early, since patients with elevated EuroSCORES and arrhythmia have significantly higher mortality rates.
authors.affiliation: Department of Cardiac-, Thoracic-, Transplantation and Vascular Surgery, Hannover Medical School.
authors.forename: Hassina
authors.initials: H
authors.lastname: Baraki
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Saito
authors.forename: Ammar
authors.initials: A
authors.lastname: Al Ahmad
authors.forename: Bernhard
authors.initials: B
authors.lastname: Fleischer
authors.forename: Axel
authors.initials: A
authors.lastname: Haverich
authors.forename: Ingo
authors.initials: I
authors.lastname: Kutschka
mesh_terms: D000328:Adult; D000368:Aged; D057186:Comparative Effectiveness Research; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006324:Heart Arrest, Induced / Q000379:methods*; D006339:Heart Rate; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D013995:Time; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000473:pathology / Q000601:surgery