Surgery is Not Associated with Improved Survival Compared to Medical Therapy in Isolated Severe Tricuspid Regurgitation

To assess the effect of surgery for isolated severe TR on mortality, we compared survival for patients who underwent surgery to those who did not. In a propensity-matched sample considering surgery as a time-dependent covariate, there was no difference in overall survival between patients who received medical versus surgical management (HR 1.34 [0.78–2.30], p=0.288).These results underscore the importance of accounting for immortal time bias in observational comparative-effectiveness research and suggest that in patients with isolated severe TR, surgery is not associated with improved long-term survival.