Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2017 Dec 22;6(12):e007597.
doi: 10.1161/JAHA.117.007597.

Contemporary Trends in the Use and Outcomes of Surgical Treatment of Tricuspid Regurgitation

Fahad Alqahtani  1 , Chalak O Berzingi  1 , Sami Aljohani  1 , Mohamad Hijazi  1 , Ahmad Al-Hallak  1 , Mohamad Alkhouli  2   3
Affiliations
Multicenter Study

Contemporary Trends in the Use and Outcomes of Surgical Treatment of Tricuspid Regurgitation

Fahad Alqahtani et al. J Am Heart Assoc. .

Abstract

Background: Tricuspid regurgitation (TR), if untreated, is associated with an adverse impact on long-term outcomes. In recent years, there has been an increasing enthusiasm about surgical and transcatheter treatment of patients with severe TR. We aim to evaluate the contemporary trends in the use and outcomes of tricuspid valve (TV) surgery for TR using the National Inpatient Sample.

Methods and results: Between January 1, 2003 and December 31, 2014, an estimated 45 477 patients underwent TV surgery for TR in the United States, of whom 15% had isolated TV surgery and 85% had TV surgery concomitant with other cardiac surgery. There was a temporal upward trend to treat sicker patients during the study period. Patients who underwent isolated TV repair or replacement had a distinctly different clinical risk profile than those patients who underwent TV surgery simultaneous with other surgery. Isolated TV replacement was associated with high in-hospital mortality (10.9%) and high rates of permanent pacemaker implantation (34.1%) and acute kidney injury requiring dialysis (5.5%). Similarly, isolated TV repair was also associated with high in-hospital mortality (8.1%) and significant rates of permanent pacemaker implantation (10.9%) and new dialysis (4.4%). Isolated TV repair and TV replacement were both associated with protracted hospitalizations and substantial cost.

Conclusions: In contemporary practice, surgical treatment of TR remains underused and is associated with high operative morbidity and mortality, prolonged hospitalizations, and considerable cost.

Keywords: tricuspid regurgitation; tricuspid valve; tricuspid valve repair; tricuspid valve replacement.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Study flow diagram. NE indicates national estimate; and VSD, ventricular septal defect.
Figure 2
Figure 2
National trends in the use of tricuspid valve surgery in the United States between January 1, 2003 and December 31, 2014. NE indicates national estimate.
Figure 3
Figure 3
Temporal trend in isolated and combined tricuspid valve replacement for tricuspid regurgitation between January 1, 2003 and December 31, 2014. NE indicates national estimate; and TVR, tricuspid valve replacement.
Figure 4
Figure 4
National trends in in‐hospital mortality after isolated tricuspid valve surgery for tricuspid regurgitation between January 1, 2003 and December 31, 2014. TVr indicates tricuspid valve repair; and TVR, tricuspid valve replacement.
Figure 5
Figure 5
Temporal trend in isolated and combined tricuspid valve repair for tricuspid regurgitation between January 1, 2003 and December 31, 2014. NE indicates national estimate; and TVr, tricuspid valve repair.
See this image and copyright information in PMC

References

    1. Kalbacher D, Schafer U, von Bardeleben RS, Zuern CS, Bekeredjian R, Ouarrak T, Sievert H, Nickenig G, Boekstegers P, Senges J, Schillinger W, Lubos E. Impact of tricuspid valve regurgitation in surgical high‐risk patients undergoing MitraClip implantation: results from the TRAMI registry. EuroIntervention. 2017;12:e1809–e1816. - PubMed
    1. Pavasini R, Ruggerini S, Grapsa J, Biscaglia S, Tumscitz C, Serenelli M, Boriani G, Squeri A, Campo G. Role of the tricuspid regurgitation after mitraclip and transcatheter aortic valve implantation: a systematic review and meta‐analysis. Eur Heart J Cardiovasc Imaging. https://academic.oup.com/ehjcimaging/advance-article-abstract/doi/10.109.... Accessed December 12, 2017 - DOI - PubMed
    1. Dahou A, Magne J, Clavel MA, Capoulade R, Bartko PE, Bergler‐Klein J, Senechal M, Mundigler G, Burwash I, Ribeiro HB, O'Connor K, Mathieu P, Baumgartner H, Dumesnil JG, Rosenhek R, Larose E, Rodes‐Cabau J, Pibarot P. Tricuspid regurgitation is associated with increased risk of mortality in patients with low‐flow low‐gradient aortic stenosis and reduced ejection fraction: results of the multicenter TOPAS study (True or Pseudo‐Severe Aortic Stenosis). JACC Cardiovasc Interv. 2015;8:588–596. - PubMed
    1. Lindman BR, Maniar HS, Jaber WA, Lerakis S, Mack MJ, Suri RM, Thourani VH, Babaliaros V, Kereiakes DJ, Whisenant B, Miller DC, Tuzcu EM, Svensson LG, Xu K, Doshi D, Leon MB, Zajarias A. Effect of tricuspid regurgitation and the right heart on survival after transcatheter aortic valve replacement: insights from the Placement of Aortic Transcatheter Valves II inoperable cohort. Circ Cardiovasc Interv. 2015;8:e002073. - PMC - PubMed
    1. Tornos Mas P, Rodriguez‐Palomares JF, Antunes MJ. Secondary tricuspid valve regurgitation: a forgotten entity. Heart. 2015;101:1840–1848. - PMC - PubMed

Publication types

LinkOut - more resources