Clinical outcomes of tricuspid valve repair accompanying left-sided heart disease

Table 1 Characteristics and cardiovascular risk factors of the study patients

	n (%)
Age (yr)	68.3 ± 12.4
Gender
Female	101 (56)
Male	79 (44)
Dyspnea (New York Heart Association)
Class I	7 (4)
Class II	25 (14)
Class III	125 (69)
Class IV	23 (13)
Cardiac rhythm
Sinus rhythm	77 (43)
Atrial fibrillation	87 (48)
Branch block	40 (22)
Pacemaker	16 (9)
Risk factors
Arterial hypertension	79 (44)
Hypercholesterolemia	77 (43)
Tobacco	44 (24)
Diabetes	42 (23)
Lower limb or supra-aortic obstructive arteriopathy	20 (11)
Pulmonary disease	25 (14)
Cerebrovascular accident or transient ischemic attack	19 (11)
Rheumatic valve disease	40 (22)
Myocardial infarction	12 (7)
Pacemaker implantation	16 (9)
Reoperation	26 (14)
Other heart disease
Aortic regurgitation	19 (11)
Aortic stenosis	30 (17)
Combined aortic stenosis/regurgitation	15 (8)
Mitral regurgitation	99 (55)
Mitral stenosis	21 (12)
Combined mitral stenosis/regurgitation	21 (12)
Pulmonary valve regurgitation	1 (0.6)
Coronary artery disease	28 (16)
Acute endocarditis	9 (5)
Interventricular or interatrial septal defect	3 (1.7)

Table 2 Preoperative and postoperative characteristics of the study patients

	mean ± SD	n (%)
Preoperative parameter
Left ventricular ejection fraction (%)	58.6 ± 12.5
Systolic pulmonary arterial pressure (mmHg)	58.0 ± 16.7
Tricuspid regurgitation
I		9 (5)
II		69 (38)
III		70 (39)
IV		32 (18)
Left ventricular end-diastolic diameter (mm)	52.7 ± 9.5 (29-74)
Left ventricular end-systolic diameter (mm)	34.4 ± 9.3 (17-63)
Postoperative parameter
Left ventricular ejection fraction (%)	54.4 ± 12.2 (10-82)
Systolic pulmonary arterial pressure (mmHg)	38.6 ± 10.6 (19-76)
Tricuspid regurgitation
0-I		150 (83)
II		28 (15)
III		1 (0.6)
IV		1 (0.6)
Left ventricular end-diastolic diameter (mm)	50.4 ± 7.4
Left ventricular end-systolic diameter (mm)	35.2 ± 8.3

Table 3 Univariate analyses: Parameters affecting global mortality

Variable	n (%)	Univariate HR	P
Gender (male)	79 (44)	1.38 [0.77-2.44]	0.27
Age (≥ 75 yr)	63 (35)	1.75 [0.98-3.11]	0.06
Tobacco use	44 (24)	1.16 [0.60-2.24]	0.66
Pulmonary disease	25 (14)	1.58 [0.74-3.40]	0.24
Pacemaker	16 (9)	2.40 [1.12-5.13]	0.02
Branch block	40 (22)	1.88 [1.01-3.47]	0.04
Previous heart failure	75 (42)	1.67 [0.94-2.95]	0.08
Ejection fraction (> 50%)	132 (73)	0.49 [0.25-0.98]	0.044
Hypertension	79 (44)	1.81 [1.01-3.20]	0.04
Diabetes on insulin	8 (4)	2.33 [0.83-6.51]	0.11
Aortic regurgitation	19 (11)	0.52 [0.16-1.67]	0.27
Aortic disease	15 (8)	1.29 [0.51-3.26]	0.59
Mitral regurgitation	99 (55)	1.01 [0.56-1.79]	0.98
Mitral stenosis	21 (12)	0.96 [0.38-2.44]	0.93
Mitral disease	21 (12)	0.55 [0.19-1.54]	0.26
Dyslipidemia	77 (43)	0.88 [0.49-1.57]	0.67
NIDD	34 (19)	1.31 [0.64-2.64]	0.45
Cerebrovascular accident	19 (11)	1.44 [0.60-3.40]	0.41
Myocardial infarction	12 (7)	1.70 [0.67-4.30]	0.26
New York Heart Association (III/IV)	148 (82)	1.99 [0.78-5.04]	0.14
Redo vs Tridux	26 (14)	1.49 [0.74-3.00]	0.26
Double valve replacement associated with tricuspid repair	43 (24)	2.21 [1.11-4.39]	0.024
Sinus rhythm	77 (43)	0.74 [0.41-1.35]	0.33
Sovering ring	156 (87)	1.10 [0.49-2.46]	0.81
Bex device	20 (11)	1.16 [0.52-2.60]	0.71
Systolic pulmonary artery pressure (> 59 mmHg)	98 (54)	1.06 [0.60-1.88]	0.83
Systolic pulmonary artery pressure (> 49 mmHg)	31 (17)	1.16 [0.56-2.40]	0.69
Tricuspid annulus diameter (> 40 mm)	20 (11)	0.31 [0.07-1.27]	0.10
Postoperative ejection fraction (> 50%)	98 (66)	2.58 [1.31-5.08]	0.006

HR: Hazard ratio.

Table 4 Prognostic factors for mortality in multivariate analyses

Variable	n (%)	Univariate		Multivariate
		HR	P	HR	P
Aortic stenosis	30 (17)	2.69 [1.24-5.42]	0.011	2.60 [1.15-5.85]	0.021
Coronary disease	28 (16)	4.12 [2.06-8.21]	< 0.001	2.79 [1.26-6.20]	0.012
Mitral-valve repair	38 (21)	0.27 [0.08-0.88]	0.03	0.32 [0.10-0.98]	0.046
Infective endocarditis	9 (5)	5.06 [1.7-14.62]	0.003	9.22 [2.87-29.62]	< 0.001

HR: Hazard ratio.