Outcomes of Redo Isolated Tricuspid Valve Surgery After Left-sided Valve Surgery

Abstract

Objectives: This study aimed to compare early and long-term outcomes of redo isolated tricuspid surgery (RITS) after left-sided valve surgery (LSVS). Methods: We retrospectively reviewed 173 patients underwent RITS for severe tricuspid regurgitation after previous LSVS from January 1999 to December 2019. Patients were divided into two groups: RITS by median sternotomy (m-RITS, n = 78) and by totally endoscopic approach (e-RITS, n = 95). Perioperative outcomes and follow-up results were analyzed. Results: There were 19 (11%) in-hospital deaths (14.1% in m-RITS and 8.4% in e-RITS, p = 0.234) that decreased from 16.7% (1999–2014) to 6.9% (2015–2019) (p = 0.044). Tricuspid valve replacement [odds ratio (OR) = 6.778, 95% confidence interval (CI): 1.370–33.549, p = 0.019] and NYHA function class IV (OR = 8.525, 95% CI: 2.153–33.760, p = 0.002) were independent risk factors of in-hospital mortality. The overall 1-, 5-year, 10-year, and 15-year survival rates were 97.2% (95% CI: 94.5–99.9%),80.3% (95% CI: 71.7–88.9%), 59.2% (95% CI: 43.5–75.5%) and 49.3% (95% CI: 27.2–71.4%), respectively. Conclusion: Patients undergoing redo isolated tricuspid valve surgery carry a high risk of early mortality. Satisfactory results are achievable with endoscopic tricuspid valve surgery and repair results in lower surgical mortality than replacement with acceptable residual tricuspid regurgitation.