Affiliation:
1. School of Medicine Chang Gung University Taoyuan City Taiwan
2. Division of Cardiac Surgery Department of Surgery Chang Gung Memorial Hospital Linkou Medical Center Taoyuan City Taiwan
3. Center for Big Data Analytics and Statistics Chang Gung Memorial Hospital Linkou Medical Center Taoyuan City Taiwan
4. Department of Anesthesiology Chang Gung Memorial Hospital Linkou Medical Center Chang Gung University Taoyuan City Taiwan
5. Department of Cardiology Chang Gung Memorial Hospital Linkou Medical Center Taoyuan City Taiwan
Abstract
Background
Surgery for tricuspid valve (
TV
) diseases is associated with poor prognosis, but few studies have described the long‐term outcomes by comparing
TV
repair and replacement in isolated and concomitant
TV
surgeries separately.
Methods and Results
Between 2000 and 2013, adult patients who underwent
TV
repair or replacement surgeries were identified from the Taiwan National Health Insurance Research Database. Outcomes of interest included all‐cause mortality, composite outcome, and readmission attributable to any cause. Inverse probability of treatment weighting was used to reduce confounding effects. A total of 2644 patients with a mean follow‐up of 4.9 years were included. Of them, 12.6% and 87.4% underwent isolated and concomitant
TV
surgery, respectively. The in‐hospital mortality rates for isolated and concomitant
TV
surgery were 8.7% and 8.6%, respectively, whereas all‐cause mortality rates were 41.7% and 36.8%, respectively. Compared with
TV
replacement,
TV
repair demonstrated significantly lower risks of all‐cause mortality (concomitant: hazard ratio [
HR
], 0.76; 95%
CI,
0.59–0.99), composite outcome (isolated: subdistribution
HR
, 0.55; 95%
CI,
0.35–0.89; concomitant: subdistribution
HR
, 0.63; 95%
CI,
0.46–0.86), and readmission (isolated: subdistribution
HR
, 0.64; 95%
CI,
0.46–0.91; concomitant: subdistribution
HR
, 0.72; 95%
CI,
0.60–0.86), except insignificant difference in all‐cause mortality in isolated surgery.
Conclusions
Compared with replacement,
TV
repair is associated with better short‐ and long‐term outcomes in both isolated and concomitant
TV
surgery. However, further prospective clinical trials are warranted.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
33 articles.
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