4 years ago

Severity of Tricuspid Regurgitation is Associated with Long Term Mortality

The aim of this study was to determine the association between intraoperative/pre-surgical grade of tricuspid regurgitation (TR) and mortality. Additionally, we sought to determine if surgical correction of TR correlated with an increased chance of survival as compared to patients with uncorrected TR. Methods Grade of TR assessed by intraoperative TEE prior to surgical intervention was reviewed for 23,685 cardiac surgery patients between 1990 and 2014. Cox proportional hazard regression models were used to determine association between grade of TR and the primary end-point of all-cause mortality. Association between tricuspid valve (TV) surgery and survival was determined with Cox proportional hazard regression model after matching for grade of TR. Results Kaplan-Meier survival curves demonstrated a relationship between all grades of TR. Multivariable analysis of the entire cohort demonstrated significantly increased mortality for moderate (HR, 1.24; 95% CI, 1.1 to 1.4; P=<.0001) and severe TR (HR, 2.02; 95% CI, 1.57 to 2.6; P=<.0001). Mild TR displayed a trend for mortality (HR 1.07, 95% CI 0.99-1.16, P=0.075). After matching for grade of TR and additional confounders, patients who underwent TV surgery had a statistically significant increased likelihood of survival (HR, 0.74; 95% CI, 0.61 to 0.91; P=.004). Conclusion Our study of over 20,000 patients demonstrates that grade of TR is associated with increased risk of mortality after cardiac surgery. Additionally, all patients who underwent TV surgery, had a statistically significantly increased likelihood of survival compared to those with the same degree of TR who did not have TV surgery.

Publisher URL: www.sciencedirect.com/science

DOI: S0022522317324297

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