TY - JOUR
T1 - Staging right heart failure in patients with tricuspid regurgitation undergoing tricuspid surgery
AU - Galloo, Xavier
AU - Stassen, Jan
AU - Butcher, Steele C.
AU - Meucci, Maria Chiara
AU - Dietz, Marlieke F.
AU - Mertens, Bart J.A.
AU - Prihadi, Edgard A.
AU - van der Bijl, Pieter
AU - Marsan, Nina Ajmone
AU - Braun, Jerry
AU - Bax, Jeroen J.
AU - Delgado, Victoria
N1 - Funding Information: Jan Stassen received funding from the European Society of Cardiology (ESC Training Grant App000064741). Steele C. Butcher received funding from the European Society of Cardiology (ESC Research Grant App000080404). Publisher Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - OBJECTIVES: This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery. METHODS: Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages according to the presence of right ventricular (RV) dysfunction and clinical signs of right heart failure: stage 1 was defined as no RV dysfunction and no signs of right heart failure; stage 2 indicated RV dysfunction without signs of right heart failure; stage 3 included RV dysfunction and signs of right heart failure; and stage 4 was defined as RV dysfunction and refractory signs of right heart failure at rest. RESULTS: A total of 278 patients [mean age 64 (12), 49% males] were included, of whom 34 (12%) patients were classified as stages 1 and 2, 141 (51%) as stage 3 and 103 (37%) as stage 4 right heart failure. The majority of patients (91%) had TV surgery concomitant to left-sided valve surgery or coronary artery bypass grafting and 95% underwent TV annuloplasty. Cumulative survival rates were 89%, 78% and 61% at 1 month, 1 year and 5 years, respectively. Stages 1 and 2 and stage 3 were independently associated with better survival compared to stage 4 (hazard ratio: 0.391 [95% confidence interval: 0.186–0.823] and 0.548 [95% confidence interval: 0.369–0.813], respectively). CONCLUSIONS: Patients with significant TR undergoing TV surgery and diagnosed without advanced right heart failure have better survival as compared to patients with right heart failure.
AB - OBJECTIVES: This study evaluated the prognostic value of staging right heart failure in patients with significant tricuspid regurgitation (TR) undergoing tricuspid valve (TV) surgery. METHODS: Patients with significant TR who underwent TV surgery were divided into 4 right heart failure stages according to the presence of right ventricular (RV) dysfunction and clinical signs of right heart failure: stage 1 was defined as no RV dysfunction and no signs of right heart failure; stage 2 indicated RV dysfunction without signs of right heart failure; stage 3 included RV dysfunction and signs of right heart failure; and stage 4 was defined as RV dysfunction and refractory signs of right heart failure at rest. RESULTS: A total of 278 patients [mean age 64 (12), 49% males] were included, of whom 34 (12%) patients were classified as stages 1 and 2, 141 (51%) as stage 3 and 103 (37%) as stage 4 right heart failure. The majority of patients (91%) had TV surgery concomitant to left-sided valve surgery or coronary artery bypass grafting and 95% underwent TV annuloplasty. Cumulative survival rates were 89%, 78% and 61% at 1 month, 1 year and 5 years, respectively. Stages 1 and 2 and stage 3 were independently associated with better survival compared to stage 4 (hazard ratio: 0.391 [95% confidence interval: 0.186–0.823] and 0.548 [95% confidence interval: 0.369–0.813], respectively). CONCLUSIONS: Patients with significant TR undergoing TV surgery and diagnosed without advanced right heart failure have better survival as compared to patients with right heart failure.
KW - Prognosis
KW - Right heart failure
KW - Tricuspid valve surgery
UR - http://www.scopus.com/inward/record.url?scp=85134429113&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ejcts/ezac290
DO - https://doi.org/10.1093/ejcts/ezac290
M3 - Article
C2 - 35511132
SN - 1010-7940
VL - 62
JO - European journal of cardio-thoracic surgery
JF - European journal of cardio-thoracic surgery
IS - 2
M1 - ezac290
ER -