Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective
Objective: To evaluate the impact of pulmonary hypertension and right ventricular dysfunction on outcomes of isolated tricuspid valve surgery. Methods: From 2004 to 2022, 298 patients (age 71.0 ± years, 59.4% female) underwent isolated tricuspid valve surgery. Pulmonary hypertension was defined as r...
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2025-04-01
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| Series: | JTCVS Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S266627362500035X |
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| author | Salah E. Altarabsheh, MD Juan A. Crestanello, MD Nishant Saran, MD Richard C. Daly, MD Joseph A. Dearani, MD Kevin L. Greason, MD John M. Stulak, MD Austin Todd, MS Phillip G. Rowse, MD Arman Arghami, MD Gabor Bagameri, MD Mauricio A. Villavicencio, MD Hartzell V. Schaff, MD Vidhu Anand, MBBS |
| author_facet | Salah E. Altarabsheh, MD Juan A. Crestanello, MD Nishant Saran, MD Richard C. Daly, MD Joseph A. Dearani, MD Kevin L. Greason, MD John M. Stulak, MD Austin Todd, MS Phillip G. Rowse, MD Arman Arghami, MD Gabor Bagameri, MD Mauricio A. Villavicencio, MD Hartzell V. Schaff, MD Vidhu Anand, MBBS |
| author_sort | Salah E. Altarabsheh, MD |
| collection | DOAJ |
| description | Objective: To evaluate the impact of pulmonary hypertension and right ventricular dysfunction on outcomes of isolated tricuspid valve surgery. Methods: From 2004 to 2022, 298 patients (age 71.0 ± years, 59.4% female) underwent isolated tricuspid valve surgery. Pulmonary hypertension was defined as right ventricular systolic pressure ≥50 mm Hg, and right ventricular dysfunction as right ventricular fractional area change <32% on preoperative transthoracic echocardiogram. Patients were stratified into 4 groups: group I: No pulmonary hypertension or right ventricular dysfunction (n = 199), group II: pulmonary hypertension without right ventricular dysfunction (n = 45), group III: right ventricular dysfunction without pulmonary hypertension (n = 43), and group IV: pulmonary hypertension and right ventricular dysfunction (n = 11). Uni- and multivariable analyses were performed to evaluate association of pulmonary hypertension and right ventricular function with outcomes. Results: Tricuspid valve replacement was performed in 218 (73.2%) and repair in 80 (26.8%) patients. Operative mortality was 4.7%, similar for reoperations (5.2%) and primary procedures (4.5%) (P = .907). Median follow-up was 5.4 (interquartile range, 2.3-12.5) years, survival was 74.4%, 48.4%, 39.8%, and 67.3% in groups I-IV, respectively (P < .0001). Multivariable analysis identified pulmonary hypertension (hazard ratio, 2.9; 1.83-4.62, P < .001) and right ventricular dysfunction (hazard ratio, 2.83; 1.76-4.56, P < .001) as independent predictors of greater long-term all-cause mortality, in addition to older age (P < .001) and severe chronic lung disease (P < .001). Conclusions: Among patients who underwent isolated tricuspid valve surgery, presence of pulmonary hypertension or right ventricular dysfunction at baseline is linked to greater long-term mortality. |
| format | Article |
| id | doaj-art-0ea7dea0d3e74564a9703e39caeac0c7 |
| institution | DOAJ |
| issn | 2666-2736 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
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| series | JTCVS Open |
| spelling | doaj-art-0ea7dea0d3e74564a9703e39caeac0c72025-08-20T03:15:03ZengElsevierJTCVS Open2666-27362025-04-012411512610.1016/j.xjon.2025.01.009Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspectiveSalah E. Altarabsheh, MD0Juan A. Crestanello, MD1Nishant Saran, MD2Richard C. Daly, MD3Joseph A. Dearani, MD4Kevin L. Greason, MD5John M. Stulak, MD6Austin Todd, MS7Phillip G. Rowse, MD8Arman Arghami, MD9Gabor Bagameri, MD10Mauricio A. Villavicencio, MD11Hartzell V. Schaff, MD12Vidhu Anand, MBBS13Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Quantitative Health Sciences, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Surgery, Mayo Clinic, Rochester, MinnDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, Minn; Address for reprints: Vidhu Anand, MBBS, Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, 200 First St SW, Rochester, MN 55905.Objective: To evaluate the impact of pulmonary hypertension and right ventricular dysfunction on outcomes of isolated tricuspid valve surgery. Methods: From 2004 to 2022, 298 patients (age 71.0 ± years, 59.4% female) underwent isolated tricuspid valve surgery. Pulmonary hypertension was defined as right ventricular systolic pressure ≥50 mm Hg, and right ventricular dysfunction as right ventricular fractional area change <32% on preoperative transthoracic echocardiogram. Patients were stratified into 4 groups: group I: No pulmonary hypertension or right ventricular dysfunction (n = 199), group II: pulmonary hypertension without right ventricular dysfunction (n = 45), group III: right ventricular dysfunction without pulmonary hypertension (n = 43), and group IV: pulmonary hypertension and right ventricular dysfunction (n = 11). Uni- and multivariable analyses were performed to evaluate association of pulmonary hypertension and right ventricular function with outcomes. Results: Tricuspid valve replacement was performed in 218 (73.2%) and repair in 80 (26.8%) patients. Operative mortality was 4.7%, similar for reoperations (5.2%) and primary procedures (4.5%) (P = .907). Median follow-up was 5.4 (interquartile range, 2.3-12.5) years, survival was 74.4%, 48.4%, 39.8%, and 67.3% in groups I-IV, respectively (P < .0001). Multivariable analysis identified pulmonary hypertension (hazard ratio, 2.9; 1.83-4.62, P < .001) and right ventricular dysfunction (hazard ratio, 2.83; 1.76-4.56, P < .001) as independent predictors of greater long-term all-cause mortality, in addition to older age (P < .001) and severe chronic lung disease (P < .001). Conclusions: Among patients who underwent isolated tricuspid valve surgery, presence of pulmonary hypertension or right ventricular dysfunction at baseline is linked to greater long-term mortality.http://www.sciencedirect.com/science/article/pii/S266627362500035Xisolated tricuspid valve surgerytricuspid regurgitationpulmonary hypertensionright ventricular functionoutcomes |
| spellingShingle | Salah E. Altarabsheh, MD Juan A. Crestanello, MD Nishant Saran, MD Richard C. Daly, MD Joseph A. Dearani, MD Kevin L. Greason, MD John M. Stulak, MD Austin Todd, MS Phillip G. Rowse, MD Arman Arghami, MD Gabor Bagameri, MD Mauricio A. Villavicencio, MD Hartzell V. Schaff, MD Vidhu Anand, MBBS Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective JTCVS Open isolated tricuspid valve surgery tricuspid regurgitation pulmonary hypertension right ventricular function outcomes |
| title | Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective |
| title_full | Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective |
| title_fullStr | Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective |
| title_full_unstemmed | Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective |
| title_short | Impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgeryCentral MessagePerspective |
| title_sort | impact of pulmonary hypertension and right ventricular function on outcomes of isolated tricuspid valve surgerycentral messageperspective |
| topic | isolated tricuspid valve surgery tricuspid regurgitation pulmonary hypertension right ventricular function outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S266627362500035X |
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