Perioperative factors associated with short-term outcomes after tricuspid valve replacement / 中华胸心血管外科杂志

ABSTRACT

Objective This study aimed to investigate the factors associated with short-term survival and morbidity after tricuspid valve replacement(TVR).Methods This was a retrospective study of 273consecutive patients who underwent TVR at the Beijing Anzhen Hospital over a 25-year period(from November 1993 to August 2018).Results The overall 30-day mortality was 14％.Multivariate analysis showed that the dose of frusemide(OR =1.018,95％ CI:1.005-1.031;P =0.007)was an independent predictor of short-term death after TVR.The NYHA (OR =2.173,95 ％ CI:1.018-4.002;P =0.013)and cardiopulmonary bypass time(OR =1.008,95％ CI:1.002-1.013;P =0.004) were independently associated with the low output syndrome (LOS).The dose of frusemide (OR =1.025,95％ CI:1.009-1.041;P =0.003)、NYHA (OR =5.837,95％ CI:2.177-15.650;P =0.000)、cardiopulmonary bypass time (OR =1.012,95％ CI:1.005-1.020;P =0.002) and diameter of right atrium(OR =1.025,95 ％ CI:1.002-1.048;P =0.033) were independently associated with acute renal failure.The dose of frusemide(OR =1.020,95％ CI:1.007-1.033;P =0.003) 、cardiopulmonary bypass time (OR=1.014,95％CI:1.006-1.022;P＜0.001) and white cell count(OR=0.748,95％CI:0.559-0.999;P =0.050) were independently associated with mechanical respiratory assistant ＞ 3 days.Conclusion This study identified a number of factors that were independently associated with short-term mortality,postoperative LOS,acute renal failure,and mechanical respiratory assistant ＞ 3 days.Long-term medical conservative treatment may affect the effect of snrgical treatment.Early surgical treatment is crucial for optimal outcomes when the dosage of frusemide ＞ 20 mg/day.