Perioperative factors associated with short- and long-term outcomes after tricuspid valve replacement

Abstract

OBJECTIVES: Appropriate patient selection for tricuspid valve replacement (TVR) is crucial for optimal outcomes, but the objective criteria for clinical decision-making remain poorly defined. This study aimed to investigate the factors associated with short- and long-term survival and morbidity. METHODS: This was a retrospective study of 202 consecutive patients who underwent TVR at the Beijing Anzhen Hospital over a 21-year period (from November 1993 to March 2014). Data were extracted from the hospital's computerized database with additional information obtained through mail or telephone interview. RESULTS: The overall 30-day mortality was 16%. Multivariate analysis showed that the dose of frusemide [odds ratio (OR) = 1.021, 95% confidence interval (95% CI): 1.003-1.038; P = 0.018] was an independent predictor of short-term death after TVR. The dose of frusemide (OR = 1.024, 95% CI: 1.008-1.040; P = 0.002), previous operation (OR = 4.681, 95% CI: 1.938-11.310; P = 0.01) and cardiopulmonary bypass time (OR = 1.013, 95% CI: 1.007-1.020; P < 0.001) were independently associated with the low output syndrome (LOS). After 8.2 ± 5.6 (range 1-22) years of follow-up, the survival rates were 75 ± 3, 71 ± 4 and 63 ± 5% at 5, 10 and 15 years, respectively. Preoperative hypoproteinaemia and postoperative LOS were independently associated with long-term mortality. CONCLUSIONS: This study identified a number of factors that were independently associated with short-term mortality, short-term LOS and long-term mortality of patients after TVR.