Late Outcomes of Valve Repair Versus Replacement in Isolated and Concomitant Tricuspid Valve Surgery: A Nationwide Cohort Study.
J Am Heart Assoc
; 9(8): e015637, 2020 04 21.
Article
em En
| MEDLINE
| ID: mdl-32301369
ABSTRACT
Background Surgery for tricuspid valve (TV) diseases is associated with poor prognosis, but few studies have described the long-term outcomes by comparing TV repair and replacement in isolated and concomitant TV surgeries separately. Methods and Results Between 2000 and 2013, adult patients who underwent TV repair or replacement surgeries were identified from the Taiwan National Health Insurance Research Database. Outcomes of interest included all-cause mortality, composite outcome, and readmission attributable to any cause. Inverse probability of treatment weighting was used to reduce confounding effects. A total of 2644 patients with a mean follow-up of 4.9 years were included. Of them, 12.6% and 87.4% underwent isolated and concomitant TV surgery, respectively. The in-hospital mortality rates for isolated and concomitant TV surgery were 8.7% and 8.6%, respectively, whereas all-cause mortality rates were 41.7% and 36.8%, respectively. Compared with TV replacement, TV repair demonstrated significantly lower risks of all-cause mortality (concomitant hazard ratio [HR], 0.76; 95% CI, 0.59-0.99), composite outcome (isolated subdistribution HR, 0.55; 95% CI, 0.35-0.89; concomitant subdistribution HR, 0.63; 95% CI, 0.46-0.86), and readmission (isolated subdistribution HR, 0.64; 95% CI, 0.46-0.91; concomitant subdistribution HR, 0.72; 95% CI, 0.60-0.86), except insignificant difference in all-cause mortality in isolated surgery. Conclusions Compared with replacement, TV repair is associated with better short- and long-term outcomes in both isolated and concomitant TV surgery. However, further prospective clinical trials are warranted.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Cirurgia_oncologica
Base de dados:
MEDLINE
Assunto principal:
Valva Tricúspide
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Implante de Prótese de Valva Cardíaca
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Anuloplastia da Valva Cardíaca
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Doenças das Valvas Cardíacas
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Am Heart Assoc
Ano de publicação:
2020
Tipo de documento:
Article