Retrospective cohort analysis of 926 tricuspid valve surgeries: Clinical and hemodynamic outcomes with propensity score analysis
Background The objectives were to describe morbidity and mortality after tricuspid valve (TV) surgery, to compare outcomes after repair versus replacement, and to assess risk factors for mortality and tricuspid regurgitation (TR) recurrence. Methods A retrospective cohort study including 926 consecu...
Gespeichert in:
| Veröffentlicht in: | The American heart journal 2012-05, Vol.163 (5), p.851-858.e1 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 858.e1 |
|---|---|
| container_issue | 5 |
| container_start_page | 851 |
| container_title | The American heart journal |
| container_volume | 163 |
| creator | Marquis-Gravel, Guillaume, MD, MSc Bouchard, Denis, MD, MSc, FRCSC Perrault, Louis P., MD, PhD, FRCSC Pagé, Pierre, MD, FRCSC Jeanmart, Hugues, MD, FRCSC Demers, Philippe, MD, FRCSC Carrier, Michel, MD, FRCSC Cartier, Raymond, MD, FRCSC Poirier, Nancy C., MD, FRCSC Hébert, Yves, MD, FRCSC Pellerin, Michel, MD, FRCSC |
| description | Background The objectives were to describe morbidity and mortality after tricuspid valve (TV) surgery, to compare outcomes after repair versus replacement, and to assess risk factors for mortality and tricuspid regurgitation (TR) recurrence. Methods A retrospective cohort study including 926 consecutive cases of TV surgery (792 repairs and 134 replacements) performed at the Montreal Heart Institute was conducted. Median follow-up was 4.3 years (4,657 patient-years). Median age was 62 years (interquartile range 53-69 years), and 72% of patients were women. Results Operative mortality was 14% (128 patients: 1977-1998 20%, 1999-2008 7%, P < .001). Independent risk factors for operative mortality in the 1999 to 2008 period were hypertension (odds ratio [OR] 6.03, P = .02), daily furosemide dose (by 10 mg) (OR 1.06, P = .05), weight (by 10 kg) (OR 0.36, P < .01), and cardiopulmonary bypass time (by 10 minutes) (OR 1.29, P < .001). Ten-year survival was 49% ± 2% and 38 ± 5% in the repair and replacement groups, respectively ( P = .012). At discharge, severity of TR was ≥3/4 in 13% and 2% of patients in the repair and replacement groups, respectively ( P = .01). Propensity score analysis showed that tricuspid repair was associated with higher rates of TR ≥3/4 at follow-up compared with replacement (hazard ratio 2.15, P = .02). Forty-eight reoperations (7% of patients at risk) were performed during follow-up (repair group, 6%; replacement group, 15%; P = .01). At last follow-up, New York Heart Association functional class was improved compared with baseline in both groups ( P < .001). Conclusion Tricuspid valve surgery is associated with substantial early and late mortalities but with significant functional improvement. Replacement is more effective in early and late corrections of regurgitation, but it does not translate into better survival outcomes. |
| doi_str_mv | 10.1016/j.ahj.2012.02.010 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1015243007</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0002870312000944</els_id><sourcerecordid>1015243007</sourcerecordid><originalsourceid>FETCH-LOGICAL-c466t-612df4673f6224c14052cef2d581719dd6009e7d7835c3973d466ea8c9731f003</originalsourceid><addsrcrecordid>eNp9kl2r1DAQhosonvXoD_BGAiJ403WSZpNWQZDFLzgg-HEdYjJ1s7bNmrQrvfOnO2XXc-BcCAOZwPNOJvNOUTzmsObA1Yv92u72awFcrIGCw51ixaHRpdJS3i1WACDKWkN1UTzIeU9XJWp1v7gQQoGulVwVfz7jmGI-oBvDEZmLu5hGZgfbzTlkFlvWCMXGFNyUD8Gzo-0Iy1P6gSlgfsm2XRiCsx1pPNthH_082D44FqfRxR4z-x3GHTukeMAhh3Fm2cWE1088LO61tsv46HxeFt_evf26_VBefXr_cfvmqnRSqbFUXPhWKl21SgjpuISNcNgKv6m55o33CqBB7XVdbVzV6MqTDG3tKOUtQHVZPD_VpU5-TZhH04fssOvsgHHKhga6EbIC0IQ-vYXu45SoX6I2IFWltWqI4ifK0fxywtYcUuhtmqnUUk2ZvSF7zGKPAQq-NPHkXHn63qO_Vvzzg4BnZ8BmGmqb7OBCvuEUgcA5ca9OHNLIjgGTyS7g4NCHRFYaH8N_23h9S-3OLv7EGfPNb00mgfmy7NGyRlxQ1khZ_QU8IsHb</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504637769</pqid></control><display><type>article</type><title>Retrospective cohort analysis of 926 tricuspid valve surgeries: Clinical and hemodynamic outcomes with propensity score analysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Marquis-Gravel, Guillaume, MD, MSc ; Bouchard, Denis, MD, MSc, FRCSC ; Perrault, Louis P., MD, PhD, FRCSC ; Pagé, Pierre, MD, FRCSC ; Jeanmart, Hugues, MD, FRCSC ; Demers, Philippe, MD, FRCSC ; Carrier, Michel, MD, FRCSC ; Cartier, Raymond, MD, FRCSC ; Poirier, Nancy C., MD, FRCSC ; Hébert, Yves, MD, FRCSC ; Pellerin, Michel, MD, FRCSC</creator><creatorcontrib>Marquis-Gravel, Guillaume, MD, MSc ; Bouchard, Denis, MD, MSc, FRCSC ; Perrault, Louis P., MD, PhD, FRCSC ; Pagé, Pierre, MD, FRCSC ; Jeanmart, Hugues, MD, FRCSC ; Demers, Philippe, MD, FRCSC ; Carrier, Michel, MD, FRCSC ; Cartier, Raymond, MD, FRCSC ; Poirier, Nancy C., MD, FRCSC ; Hébert, Yves, MD, FRCSC ; Pellerin, Michel, MD, FRCSC</creatorcontrib><description>Background The objectives were to describe morbidity and mortality after tricuspid valve (TV) surgery, to compare outcomes after repair versus replacement, and to assess risk factors for mortality and tricuspid regurgitation (TR) recurrence. Methods A retrospective cohort study including 926 consecutive cases of TV surgery (792 repairs and 134 replacements) performed at the Montreal Heart Institute was conducted. Median follow-up was 4.3 years (4,657 patient-years). Median age was 62 years (interquartile range 53-69 years), and 72% of patients were women. Results Operative mortality was 14% (128 patients: 1977-1998 20%, 1999-2008 7%, P < .001). Independent risk factors for operative mortality in the 1999 to 2008 period were hypertension (odds ratio [OR] 6.03, P = .02), daily furosemide dose (by 10 mg) (OR 1.06, P = .05), weight (by 10 kg) (OR 0.36, P < .01), and cardiopulmonary bypass time (by 10 minutes) (OR 1.29, P < .001). Ten-year survival was 49% ± 2% and 38 ± 5% in the repair and replacement groups, respectively ( P = .012). At discharge, severity of TR was ≥3/4 in 13% and 2% of patients in the repair and replacement groups, respectively ( P = .01). Propensity score analysis showed that tricuspid repair was associated with higher rates of TR ≥3/4 at follow-up compared with replacement (hazard ratio 2.15, P = .02). Forty-eight reoperations (7% of patients at risk) were performed during follow-up (repair group, 6%; replacement group, 15%; P = .01). At last follow-up, New York Heart Association functional class was improved compared with baseline in both groups ( P < .001). Conclusion Tricuspid valve surgery is associated with substantial early and late mortalities but with significant functional improvement. Replacement is more effective in early and late corrections of regurgitation, but it does not translate into better survival outcomes.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2012.02.010</identifier><identifier>PMID: 22607864</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Age ; Aged ; Analysis of Variance ; Biological and medical sciences ; Cardiac Surgical Procedures - methods ; Cardiac Surgical Procedures - mortality ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cohort Studies ; Coronary vessels ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Heart surgery ; Heart Valve Diseases - diagnostic imaging ; Heart Valve Diseases - mortality ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - methods ; Heart Valve Prosthesis Implantation - mortality ; Hemodynamics - physiology ; Hospital Mortality - trends ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Patients ; Postoperative Complications - epidemiology ; Postoperative Complications - physiopathology ; Prostheses ; Recurrence ; Registries ; Reoperation - methods ; Retrospective Studies ; Rheumatic diseases ; Risk Assessment ; Severity of Illness Index ; Statistical analysis ; Statistics, Nonparametric ; Studies ; Survival Rate ; Treatment Outcome ; Tricuspid Valve - diagnostic imaging ; Tricuspid Valve - surgery ; Variables</subject><ispartof>The American heart journal, 2012-05, Vol.163 (5), p.851-858.e1</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited May 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c466t-612df4673f6224c14052cef2d581719dd6009e7d7835c3973d466ea8c9731f003</citedby><cites>FETCH-LOGICAL-c466t-612df4673f6224c14052cef2d581719dd6009e7d7835c3973d466ea8c9731f003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870312000944$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26260011$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22607864$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marquis-Gravel, Guillaume, MD, MSc</creatorcontrib><creatorcontrib>Bouchard, Denis, MD, MSc, FRCSC</creatorcontrib><creatorcontrib>Perrault, Louis P., MD, PhD, FRCSC</creatorcontrib><creatorcontrib>Pagé, Pierre, MD, FRCSC</creatorcontrib><creatorcontrib>Jeanmart, Hugues, MD, FRCSC</creatorcontrib><creatorcontrib>Demers, Philippe, MD, FRCSC</creatorcontrib><creatorcontrib>Carrier, Michel, MD, FRCSC</creatorcontrib><creatorcontrib>Cartier, Raymond, MD, FRCSC</creatorcontrib><creatorcontrib>Poirier, Nancy C., MD, FRCSC</creatorcontrib><creatorcontrib>Hébert, Yves, MD, FRCSC</creatorcontrib><creatorcontrib>Pellerin, Michel, MD, FRCSC</creatorcontrib><title>Retrospective cohort analysis of 926 tricuspid valve surgeries: Clinical and hemodynamic outcomes with propensity score analysis</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background The objectives were to describe morbidity and mortality after tricuspid valve (TV) surgery, to compare outcomes after repair versus replacement, and to assess risk factors for mortality and tricuspid regurgitation (TR) recurrence. Methods A retrospective cohort study including 926 consecutive cases of TV surgery (792 repairs and 134 replacements) performed at the Montreal Heart Institute was conducted. Median follow-up was 4.3 years (4,657 patient-years). Median age was 62 years (interquartile range 53-69 years), and 72% of patients were women. Results Operative mortality was 14% (128 patients: 1977-1998 20%, 1999-2008 7%, P < .001). Independent risk factors for operative mortality in the 1999 to 2008 period were hypertension (odds ratio [OR] 6.03, P = .02), daily furosemide dose (by 10 mg) (OR 1.06, P = .05), weight (by 10 kg) (OR 0.36, P < .01), and cardiopulmonary bypass time (by 10 minutes) (OR 1.29, P < .001). Ten-year survival was 49% ± 2% and 38 ± 5% in the repair and replacement groups, respectively ( P = .012). At discharge, severity of TR was ≥3/4 in 13% and 2% of patients in the repair and replacement groups, respectively ( P = .01). Propensity score analysis showed that tricuspid repair was associated with higher rates of TR ≥3/4 at follow-up compared with replacement (hazard ratio 2.15, P = .02). Forty-eight reoperations (7% of patients at risk) were performed during follow-up (repair group, 6%; replacement group, 15%; P = .01). At last follow-up, New York Heart Association functional class was improved compared with baseline in both groups ( P < .001). Conclusion Tricuspid valve surgery is associated with substantial early and late mortalities but with significant functional improvement. Replacement is more effective in early and late corrections of regurgitation, but it does not translate into better survival outcomes.</description><subject>Age</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Cardiac Surgical Procedures - mortality</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cohort Studies</subject><subject>Coronary vessels</subject><subject>Echocardiography, Doppler</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart surgery</subject><subject>Heart Valve Diseases - diagnostic imaging</subject><subject>Heart Valve Diseases - mortality</subject><subject>Heart Valve Diseases - surgery</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Heart Valve Prosthesis Implantation - mortality</subject><subject>Hemodynamics - physiology</subject><subject>Hospital Mortality - trends</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Patients</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Prostheses</subject><subject>Recurrence</subject><subject>Registries</subject><subject>Reoperation - methods</subject><subject>Retrospective Studies</subject><subject>Rheumatic diseases</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Statistical analysis</subject><subject>Statistics, Nonparametric</subject><subject>Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Tricuspid Valve - diagnostic imaging</subject><subject>Tricuspid Valve - surgery</subject><subject>Variables</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl2r1DAQhosonvXoD_BGAiJ403WSZpNWQZDFLzgg-HEdYjJ1s7bNmrQrvfOnO2XXc-BcCAOZwPNOJvNOUTzmsObA1Yv92u72awFcrIGCw51ixaHRpdJS3i1WACDKWkN1UTzIeU9XJWp1v7gQQoGulVwVfz7jmGI-oBvDEZmLu5hGZgfbzTlkFlvWCMXGFNyUD8Gzo-0Iy1P6gSlgfsm2XRiCsx1pPNthH_082D44FqfRxR4z-x3GHTukeMAhh3Fm2cWE1088LO61tsv46HxeFt_evf26_VBefXr_cfvmqnRSqbFUXPhWKl21SgjpuISNcNgKv6m55o33CqBB7XVdbVzV6MqTDG3tKOUtQHVZPD_VpU5-TZhH04fssOvsgHHKhga6EbIC0IQ-vYXu45SoX6I2IFWltWqI4ifK0fxywtYcUuhtmqnUUk2ZvSF7zGKPAQq-NPHkXHn63qO_Vvzzg4BnZ8BmGmqb7OBCvuEUgcA5ca9OHNLIjgGTyS7g4NCHRFYaH8N_23h9S-3OLv7EGfPNb00mgfmy7NGyRlxQ1khZ_QU8IsHb</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Marquis-Gravel, Guillaume, MD, MSc</creator><creator>Bouchard, Denis, MD, MSc, FRCSC</creator><creator>Perrault, Louis P., MD, PhD, FRCSC</creator><creator>Pagé, Pierre, MD, FRCSC</creator><creator>Jeanmart, Hugues, MD, FRCSC</creator><creator>Demers, Philippe, MD, FRCSC</creator><creator>Carrier, Michel, MD, FRCSC</creator><creator>Cartier, Raymond, MD, FRCSC</creator><creator>Poirier, Nancy C., MD, FRCSC</creator><creator>Hébert, Yves, MD, FRCSC</creator><creator>Pellerin, Michel, MD, FRCSC</creator><general>Elsevier Inc</general><general>Mosby</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Retrospective cohort analysis of 926 tricuspid valve surgeries: Clinical and hemodynamic outcomes with propensity score analysis</title><author>Marquis-Gravel, Guillaume, MD, MSc ; Bouchard, Denis, MD, MSc, FRCSC ; Perrault, Louis P., MD, PhD, FRCSC ; Pagé, Pierre, MD, FRCSC ; Jeanmart, Hugues, MD, FRCSC ; Demers, Philippe, MD, FRCSC ; Carrier, Michel, MD, FRCSC ; Cartier, Raymond, MD, FRCSC ; Poirier, Nancy C., MD, FRCSC ; Hébert, Yves, MD, FRCSC ; Pellerin, Michel, MD, FRCSC</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c466t-612df4673f6224c14052cef2d581719dd6009e7d7835c3973d466ea8c9731f003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Cardiac Surgical Procedures - mortality</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cohort Studies</topic><topic>Coronary vessels</topic><topic>Echocardiography, Doppler</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart surgery</topic><topic>Heart Valve Diseases - diagnostic imaging</topic><topic>Heart Valve Diseases - mortality</topic><topic>Heart Valve Diseases - surgery</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Heart Valve Prosthesis Implantation - mortality</topic><topic>Hemodynamics - physiology</topic><topic>Hospital Mortality - trends</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Patients</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Prostheses</topic><topic>Recurrence</topic><topic>Registries</topic><topic>Reoperation - methods</topic><topic>Retrospective Studies</topic><topic>Rheumatic diseases</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Statistical analysis</topic><topic>Statistics, Nonparametric</topic><topic>Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Tricuspid Valve - diagnostic imaging</topic><topic>Tricuspid Valve - surgery</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marquis-Gravel, Guillaume, MD, MSc</creatorcontrib><creatorcontrib>Bouchard, Denis, MD, MSc, FRCSC</creatorcontrib><creatorcontrib>Perrault, Louis P., MD, PhD, FRCSC</creatorcontrib><creatorcontrib>Pagé, Pierre, MD, FRCSC</creatorcontrib><creatorcontrib>Jeanmart, Hugues, MD, FRCSC</creatorcontrib><creatorcontrib>Demers, Philippe, MD, FRCSC</creatorcontrib><creatorcontrib>Carrier, Michel, MD, FRCSC</creatorcontrib><creatorcontrib>Cartier, Raymond, MD, FRCSC</creatorcontrib><creatorcontrib>Poirier, Nancy C., MD, FRCSC</creatorcontrib><creatorcontrib>Hébert, Yves, MD, FRCSC</creatorcontrib><creatorcontrib>Pellerin, Michel, MD, FRCSC</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marquis-Gravel, Guillaume, MD, MSc</au><au>Bouchard, Denis, MD, MSc, FRCSC</au><au>Perrault, Louis P., MD, PhD, FRCSC</au><au>Pagé, Pierre, MD, FRCSC</au><au>Jeanmart, Hugues, MD, FRCSC</au><au>Demers, Philippe, MD, FRCSC</au><au>Carrier, Michel, MD, FRCSC</au><au>Cartier, Raymond, MD, FRCSC</au><au>Poirier, Nancy C., MD, FRCSC</au><au>Hébert, Yves, MD, FRCSC</au><au>Pellerin, Michel, MD, FRCSC</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retrospective cohort analysis of 926 tricuspid valve surgeries: Clinical and hemodynamic outcomes with propensity score analysis</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>163</volume><issue>5</issue><spage>851</spage><epage>858.e1</epage><pages>851-858.e1</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background The objectives were to describe morbidity and mortality after tricuspid valve (TV) surgery, to compare outcomes after repair versus replacement, and to assess risk factors for mortality and tricuspid regurgitation (TR) recurrence. Methods A retrospective cohort study including 926 consecutive cases of TV surgery (792 repairs and 134 replacements) performed at the Montreal Heart Institute was conducted. Median follow-up was 4.3 years (4,657 patient-years). Median age was 62 years (interquartile range 53-69 years), and 72% of patients were women. Results Operative mortality was 14% (128 patients: 1977-1998 20%, 1999-2008 7%, P < .001). Independent risk factors for operative mortality in the 1999 to 2008 period were hypertension (odds ratio [OR] 6.03, P = .02), daily furosemide dose (by 10 mg) (OR 1.06, P = .05), weight (by 10 kg) (OR 0.36, P < .01), and cardiopulmonary bypass time (by 10 minutes) (OR 1.29, P < .001). Ten-year survival was 49% ± 2% and 38 ± 5% in the repair and replacement groups, respectively ( P = .012). At discharge, severity of TR was ≥3/4 in 13% and 2% of patients in the repair and replacement groups, respectively ( P = .01). Propensity score analysis showed that tricuspid repair was associated with higher rates of TR ≥3/4 at follow-up compared with replacement (hazard ratio 2.15, P = .02). Forty-eight reoperations (7% of patients at risk) were performed during follow-up (repair group, 6%; replacement group, 15%; P = .01). At last follow-up, New York Heart Association functional class was improved compared with baseline in both groups ( P < .001). Conclusion Tricuspid valve surgery is associated with substantial early and late mortalities but with significant functional improvement. Replacement is more effective in early and late corrections of regurgitation, but it does not translate into better survival outcomes.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22607864</pmid><doi>10.1016/j.ahj.2012.02.010</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8703 |
| ispartof | The American heart journal, 2012-05, Vol.163 (5), p.851-858.e1 |
| issn | 0002-8703 1097-6744 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1015243007 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Age Aged Analysis of Variance Biological and medical sciences Cardiac Surgical Procedures - methods Cardiac Surgical Procedures - mortality Cardiology Cardiology. Vascular system Cardiovascular Cardiovascular disease Cohort Studies Coronary vessels Echocardiography, Doppler Female Follow-Up Studies Heart surgery Heart Valve Diseases - diagnostic imaging Heart Valve Diseases - mortality Heart Valve Diseases - surgery Heart Valve Prosthesis Heart Valve Prosthesis Implantation - methods Heart Valve Prosthesis Implantation - mortality Hemodynamics - physiology Hospital Mortality - trends Humans Kaplan-Meier Estimate Male Medical sciences Middle Aged Mortality Multivariate Analysis Patients Postoperative Complications - epidemiology Postoperative Complications - physiopathology Prostheses Recurrence Registries Reoperation - methods Retrospective Studies Rheumatic diseases Risk Assessment Severity of Illness Index Statistical analysis Statistics, Nonparametric Studies Survival Rate Treatment Outcome Tricuspid Valve - diagnostic imaging Tricuspid Valve - surgery Variables |
| title | Retrospective cohort analysis of 926 tricuspid valve surgeries: Clinical and hemodynamic outcomes with propensity score analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-19T06%3A46%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Retrospective%20cohort%20analysis%20of%20926%20tricuspid%20valve%20surgeries:%20Clinical%20and%20hemodynamic%20outcomes%20with%20propensity%20score%20analysis&rft.jtitle=The%20American%20heart%20journal&rft.au=Marquis-Gravel,%20Guillaume,%20MD,%20MSc&rft.date=2012-05-01&rft.volume=163&rft.issue=5&rft.spage=851&rft.epage=858.e1&rft.pages=851-858.e1&rft.issn=0002-8703&rft.eissn=1097-6744&rft.coden=AHJOA2&rft_id=info:doi/10.1016/j.ahj.2012.02.010&rft_dat=%3Cproquest_cross%3E1015243007%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1504637769&rft_id=info:pmid/22607864&rft_els_id=1_s2_0_S0002870312000944&rfr_iscdi=true |