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Isolated Tricuspid Valve Surgery Patient Profile, Risk Score and Outcome Association: Single Center Experience
Session:
SESSÃO DE POSTERS 54 - INTERVENÇÃO MITRAL PERCUTÂNEA E CIRURGIA CARDÍACA
Speaker:
Antonio Maria Rocha de Almeida
Congress:
CPC 2025
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
26. Cardiovascular Surgery
Subtheme:
26.2 Cardiovascular Surgery – Valves
Session Type:
Cartazes
FP Number:
---
Authors:
António Maria Rocha De Almeida; Ana Rita Bello; Pedro Magro; Joao Aquino; Inês Alves; Maria Resende; Márcio Madeira; Sara Ranchordas; Sérgio Borshoff; Marta Marques; Miguel Abecasis; Miguel Sousa Uva
Abstract
<p style="text-align:justify"><strong>Background</strong></p> <p style="text-align:justify">The tricuspid valve disease has recently earned awareness due to the significant morbidity and mortality presented by recent evidence if left untreated. This study examines isolated tricuspid valve surgery’s clinical characteristics, risk factors, and association with short and long-term outcomes.</p> <p style="text-align:justify"><strong>Methods</strong></p> <p style="text-align:justify">This retrospective cohort study analyzed 42 patients undergoing isolated tricuspid valve surgery from 2018 to 2024 at a single tertiary center. Patients were grouped based on primary or secondary tricuspid regurgitation (TR). Baseline clinical characteristics, surgical details, and outcomes were assessed, with further stratification by Triscore risk.</p> <p style="text-align:justify"><strong>Results</strong></p> <p style="text-align:justify">The study included 42 patients, with a mean age of 60±16 years, and 62% female. Primary TR was present in 48% (n=20), and secondary TR in 45% (n=19). A history of prior cardiac surgery was noted in 26%. Secondary TR patients were not significantly older (70±9 vs. 50±15 years, p=0.07) and were predominantly female (84% vs. 40%, p=0.005). They also presented with worse functional status (NYHA >2 in 74% vs. 40%, p=0.01), higher NTproBNP levels (2131 vs. 627, p=0.01), and elevated Triscore risk (>3 in 79% vs. 45%, p=0.05). There were no other differences in comorbidities prevalence between groups (table 1).</p> <p style="text-align:justify">Surgery consisted of tricuspid valve repair in 56% and replacement in 44%, with bioprostheses used in 88% of replacements. Prosthesis size averaged 31±2 mm, while annulus size for repairs was 33±2 mm, with no differences between groups. Intraoperative mortality was 0%, and complications occurred in 14% (table 2).</p> <p style="text-align:justify">During hospitalization, 26% of patients experienced complications, but the 30-day mortality rate was 0%. Patients with primary TR had non-significant more complications (42% vs. 16%, p=0.7) and a non-significant higher rate of complete AV block (15% vs. 0%, p=0.08). One-year mortality and readmission rates were both 7% (table 3). Triscore risk stratification revealed a clear association with outcomes. Patients with a Triscore >7 had a one-year mortality and hospitalization rate of 60%, compared to 11% for scores between 3-6 and 0% for scores <3 (p<0.001).</p> <p style="text-align:justify"><strong>Conclusions</strong><br /> This study highlights the increasing focus on tricuspid valve disease and the utility of the Triscore for risk stratification. Low-risk patients (Triscore <3) had excellent outcomes, with no mortality or hospitalizations in one year, demonstrating the safety and efficacy of isolated tricuspid valve surgery. On the other hand, high-risk patients (Triscore>7) had significantly worse outcomes, emphasizing the importance of careful patient selection and management. Early intervention and tailored strategies are critical to improving survival and reducing complications in this patient population.</p>
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