Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study

BackgroundTricuspid valve replacement (TVR), although accounting for a minority of heart valve surgeries, poses significant challenges, including poor patients’ condition, prosthetic complications, and increased perioperative mortality rates. Despite preferences for valvuloplasty, some cases necessi...

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Main Authors: Yingjie Ke, Linbin Hua, Shanwen Pang, Qiuji Wang, Lishan Zhong, Zhenzhong Wang, Kan Zhou, Rong Zeng, Huanlei Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2025.1532945/full
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author Yingjie Ke
Yingjie Ke
Linbin Hua
Shanwen Pang
Qiuji Wang
Lishan Zhong
Zhenzhong Wang
Kan Zhou
Rong Zeng
Huanlei Huang
Huanlei Huang
Huanlei Huang
author_facet Yingjie Ke
Yingjie Ke
Linbin Hua
Shanwen Pang
Qiuji Wang
Lishan Zhong
Zhenzhong Wang
Kan Zhou
Rong Zeng
Huanlei Huang
Huanlei Huang
Huanlei Huang
author_sort Yingjie Ke
collection DOAJ
description BackgroundTricuspid valve replacement (TVR), although accounting for a minority of heart valve surgeries, poses significant challenges, including poor patients’ condition, prosthetic complications, and increased perioperative mortality rates. Despite preferences for valvuloplasty, some cases necessitate replacement. The choice of tricuspid valve type remains controversial, and there is no consensus on surgical risk factors. Additionally, long-term follow-up reports on a large number of cases are lacking. In this study, we aimed to analyze the medical records of the largest number of patients who underwent TVR surgery.MethodsPatients who underwent TVR between 1999 and 2023 were divided into mechanical (MTVR) and bioprosthetic (BTVR) groups. Risk factors for overall mortality were analyzed.ResultsIn total, 626 patients were enrolled. The in-hospital and overall mortality rates were 12.1% and 42.8%, respectively. The in-hospital mortality rate (7.0% vs. 14.2%), incidence of acute renal insufficiency (4.3% vs. 12.2%), and hemodialysis rate (3.2% vs. 10.4%) were significantly higher in the BTVR group than in the MTVR group (P < 0.01). The median follow-up was 11 years (range 0.1–24 years). The MTVR group had significantly higher rates of long-term survival, hemorrhagic events, heart failure events, and re-operation rates than the BTVR group (P < 0.01). Multifactorial logistic regression analysis identified body weight, New York heart function classification, extracorporeal circulation time, and ventilator time as independent risk factors for in-hospital mortality. New York heart function classification during follow-up was identified as an independent risk factor for overall patient mortality.ConclusionsMTVR was superior to BTVR regarding short- and long-term outcomes. New York heart function classification was associated with short- and long-term mortality.
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spelling doaj-art-dee7f3a6f1a34fb9af6b117889b9dde72025-08-20T02:16:18ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-04-011210.3389/fsurg.2025.15329451532945Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center studyYingjie Ke0Yingjie Ke1Linbin Hua2Shanwen Pang3Qiuji Wang4Lishan Zhong5Zhenzhong Wang6Kan Zhou7Rong Zeng8Huanlei Huang9Huanlei Huang10Huanlei Huang11Department of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital’s Nanhai Hospital, The Second People’s Hospital of Nanhai District Foshan City, Foshan, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial First Veterans Hospital, Guangzhou, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, ChinaDepartment of Cardiovascular Surgery, Guangdong Provincial People’s Hospital’s Nanhai Hospital, The Second People’s Hospital of Nanhai District Foshan City, Foshan, Guangdong, ChinaSchool of Medicine, South China University of Technology, Guangzhou, ChinaBackgroundTricuspid valve replacement (TVR), although accounting for a minority of heart valve surgeries, poses significant challenges, including poor patients’ condition, prosthetic complications, and increased perioperative mortality rates. Despite preferences for valvuloplasty, some cases necessitate replacement. The choice of tricuspid valve type remains controversial, and there is no consensus on surgical risk factors. Additionally, long-term follow-up reports on a large number of cases are lacking. In this study, we aimed to analyze the medical records of the largest number of patients who underwent TVR surgery.MethodsPatients who underwent TVR between 1999 and 2023 were divided into mechanical (MTVR) and bioprosthetic (BTVR) groups. Risk factors for overall mortality were analyzed.ResultsIn total, 626 patients were enrolled. The in-hospital and overall mortality rates were 12.1% and 42.8%, respectively. The in-hospital mortality rate (7.0% vs. 14.2%), incidence of acute renal insufficiency (4.3% vs. 12.2%), and hemodialysis rate (3.2% vs. 10.4%) were significantly higher in the BTVR group than in the MTVR group (P < 0.01). The median follow-up was 11 years (range 0.1–24 years). The MTVR group had significantly higher rates of long-term survival, hemorrhagic events, heart failure events, and re-operation rates than the BTVR group (P < 0.01). Multifactorial logistic regression analysis identified body weight, New York heart function classification, extracorporeal circulation time, and ventilator time as independent risk factors for in-hospital mortality. New York heart function classification during follow-up was identified as an independent risk factor for overall patient mortality.ConclusionsMTVR was superior to BTVR regarding short- and long-term outcomes. New York heart function classification was associated with short- and long-term mortality.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1532945/fulltricuspid valve replacementbioprosthetic valveMechanical Valvelong-term follow-uprisk factors
spellingShingle Yingjie Ke
Yingjie Ke
Linbin Hua
Shanwen Pang
Qiuji Wang
Lishan Zhong
Zhenzhong Wang
Kan Zhou
Rong Zeng
Huanlei Huang
Huanlei Huang
Huanlei Huang
Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study
Frontiers in Surgery
tricuspid valve replacement
bioprosthetic valve
Mechanical Valve
long-term follow-up
risk factors
title Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study
title_full Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study
title_fullStr Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study
title_full_unstemmed Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study
title_short Long-term prognosis and risk factors in tricuspid valve replacement surgery: a single-center study
title_sort long term prognosis and risk factors in tricuspid valve replacement surgery a single center study
topic tricuspid valve replacement
bioprosthetic valve
Mechanical Valve
long-term follow-up
risk factors
url https://www.frontiersin.org/articles/10.3389/fsurg.2025.1532945/full
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