Publish in this journal
Journal Information
Share
Share
Download PDF
More article options
ePub
Visits
Not available
Original article
Available online 20 December 2022
Delay of surgical treatment of severe tricuspid regurgitation and outcomes in patients with left-sided heart valve disease
Demora en el tratamiento quirúrgico de la insuficiencia tricuspídea grave y resultados en pacientes con valvulopatía izquierda
Visits
...
Yolanda Carrascala,b,
Corresponding author
ycarrascal@hotmail.com

Corresponding author:
, Bárbara Seguraa, Cristina Sáncheza, Eduardo Velascoa
a Servicio de Cirugía Cardiaca, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
b Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Universidad de Valladolid, Valladolid, Spain
Received 19 July 2022. Accepted 02 November 2022
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Abstract
Introduction and objectives

The influence of the delay between diagnosis and surgery in severe tricuspid regurgitation (TR) remains controversial. We aimed to analyze the association between delay to surgery and operative and mid-term mortality in patients with severe TR concomitant to left-valve surgery.

Methods

We conducted an observational retrospective study analyzing risk factors in patients undergoing left-valve surgery concomitant with severe TR. The clinical and demographic variables were prospectively collected. The time of first diagnosis of TR was retrospectively collected.

Results

A total of 253 patients were analyzed. TR was functional in 82.6%. The median latency between diagnosis and surgery was 24 months. Operative mortality was 12.2%. On multivariate analysis, higher operative mortality was associated with older age, worse preoperative NYHA functional class, triple valve surgery, hyponatremia, and anemia. The median follow-up was 35 months. Survival at 1 and 5 years was 85.2% and 73.7%, respectively. Mortality during follow-up was associated with male sex, preoperative massive TR, and longer latency between diagnosis and surgery.

Conclusions

The variables related to worse preoperative functional class were associated with increased operative mortality. Lower mid-term survival was associated with longer latency between diagnosis of severe TR and surgery, massive preoperative TR, and older age.

Keywords:
Tricuspid valve regurgitation
In-hospital mortality
Cardiac surgery
Abbreviations:
RH
TR
Resumen
Introducción y objetivos

La influencia de la demora entre diagnóstico y cirugía de la insuficiencia tricuspídea (IT) grave es controvertida. Analizamos la asociación entre demora quirúrgica y mortalidad, operatoria y a medio plazo, en pacientes con IT grave asociada a cirugía valvular izquierda.

Métodos

Se hizo un estudio observacional retrospectivo de factores de riesgo en pacientes operados por valvulopatía izquierda asociada a IT grave. Las variables clínicas y demográficas se recogieron prospectivamente, y retrospectivamente el momento del primer diagnóstico de IT severa.

Resultados

Se analizó a 253 pacientes. La insuficiencia tricuspídea fue funcional en el 82,6%. La mediana entre diagnóstico y cirugía fue de 24 meses. La mortalidad operatoria fue del 12,2%. En el análisis multivariante la mayor edad, peor clase funcional preoperatoria, triple cirugía valvular, hiponatremia y anemia se asociaron a mayor mortalidad operatoria. La mediana de seguimiento fue de 35 meses. La supervivencia a 1 y 5 años fue del 85,2% y 73,7%, respectivamente. El sexo masculino, la presencia de IT masiva preoperatoria y la demora entre diagnóstico de IT grave y cirugía se asociaron a mayor mortalidad durante el seguimiento.

Conclusiones

Las variables relacionadas con una peor clase funcional se asociaron al incremento de la mortalidad operatoria. La mayor latencia entre el diagnóstico de insuficiencia tricuspídea grave y cirugía y el diagnóstico preoperatorio de insuficiencia tricuspídea masiva y la edad se asociaron con una disminución de la supervivencia a medio plazo.

Palabras clave:
Insuficiencia tricuspídea
Mortalidad hospitalaria
Cirugía cardiaca

Article

These are the options to access the full texts of the publication Revista Española de Cardiología (English Edition)
Member
Members of SEC
Use the Society's website login and password here
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Revista Española de Cardiología (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

View newsletter history
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?