Persistent tricuspid regurgitation after tricuspid annuloplasty during redo valve surgery affects late survival and valve-related events

Abstract

BACKGROUND: Long-term survival and incidence of late tricuspid regurgitation (TR) were studied in patients who underwent tricuspid annuloplasty (TAP) during redo valve surgery. METHODS AND RESULTS: We retrospectively analyzed 125 patients (mean age, 64.5±10.4 years) who underwent TAP using suture (n=54, group S) or ring (n=71, group R) implantation during redo surgery in a 20-year period. There was a significant difference in prevalence of preoperative atrial fibrillation (P=0.0199). More group S patients were in New York Heart Association functional class III or IV than group R patients (P=0.0066). Mean follow-up was 6.6±5.3 years. Mortality rate for group S was 9.3%, and for group R, 7.0% (P=0.6508). Survival at 5 and 10 years was 72.2±6.6% vs. 88.1±4.0%, and 66.4±7.3% vs. 61.0±7.2%, respectively (log-rank, P=0.7235). Less than moderate TR (hazard ratio [HR], 0.113; P=0.0198) before discharge was a predictor of late survival. There was no statistically significant difference in freedom from valve-related events (log-rank, P=0.5196). A predictor of freedom from valve-related events was less than moderate TR before discharge (HR 0.428; P=0.0100). It was also a positive predictor of freedom from late TR more than mild (HR 0.070; P<0.0001). CONCLUSIONS: Less than moderate TR before discharge after TAP during redo valve surgery was an independent risk factor for better long-term outcome.