FACTORS AFFECTING LONGEVITY OF TRICUSPID VALVE REPAIR.

Background:Severe tricuspid regurgitation (TR) is an independent predictor of long-term mortality. Although TR is tolerated for many years, it will eventually lead to severe decompensated heart failure and death. The 1-year survival rate in patients with severe TR is 65%, whereas that in patients without TR is 90%. Methods: This survival retrospective and prospective study included 199 patients (66 male [33.2%] and 133 female [66.8%]) who underwent tricuspid valve repair at King Abdulaziz Cardiac Center, Riyadh, Saudi Arabia, from January 1999 until December 2012. The mean age at operation was 49.7 years SD 16.3. All patients received follow-up until February 2016. We collected data on patient demographics, family history of cardiac diseases, smoking history, patient health status and other co-morbidities prior to the operation, the surgical technique, and other associated procedures carried out during the same operation. We included echocardiograph (ECHO)results obtained pre-operation, post-operation, pre-discharge, and at the final follow-up (February 2016). Cox regression analysis (univariate and multivariate) was used to study patient survival factors. Results:The final outcomes of the operation showed 84.5% survival. The median survival time was 50 months and interquartile range 72. All patients underwent concomitant procedures such as coronary artery bypass grafting (19.1%) or other valve replacement surgeries (23.1%). The surgical technique was chosen based on the patient’s status and the surgeon’s preference. The mean hospital stay was 26.9 ± 19.3 days, which was prolonged by surgical complications. Elderly patients, prior cardiac surgery, and abnormal coronary angiogram were linked to poor prognosis (p ? 0.05). ECHO follow-up showed improvement in the functional status of the tricuspid valve. Conclusion: The tricuspid valve requires surgical intervention whenever possible so as to minimize fatal consequences. Our study revealed positive enhancement of valve function following surgery.