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Outcomes of Redo Isolated Tricuspid Valve Surgery After Left-sided Valve Surgery
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  • liang yang,
  • Kan Zhou,
  • yanchen yang,
  • Biao-Chuan He,
  • zerui chen,
  • chennan tian,
  • huanlei huang
liang yang
Guangdong Provincial People's Hospital
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Kan Zhou
Guangdong Provincial People's Hospital
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yanchen yang
Guangdong Provincial People's Hospital
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Biao-Chuan He
Guangdong Cardiovascular Institute
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zerui chen
Guangdong Provincial People's Hospital
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chennan tian
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huanlei huang
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Abstract

Objectives: This study aimed to compare early and long-term outcomes of redo isolated tricuspid surgery (RITS) after left-sided valve surgery (LSVS). Methods: We retrospectively reviewed 173 patients underwent RITS for severe tricuspid regurgitation after previous LSVS from January 1999 to December 2019. Patients were divided into two groups: RITS by median sternotomy (m-RITS, n = 78) and by totally endoscopic approach (e-RITS, n = 95). Perioperative outcomes and follow-up results were analyzed. Results: There were 19 (11%) in-hospital deaths (14.1% in m-RITS and 8.4% in e-RITS, p = 0.234) that decreased from 16.7% (1999–2014) to 6.9% (2015–2019) (p = 0.044). Tricuspid valve replacement [odds ratio (OR) = 6.778, 95% confidence interval (CI): 1.370–33.549, p = 0.019] and NYHA function class IV (OR = 8.525, 95% CI: 2.153–33.760, p = 0.002) were independent risk factors of in-hospital mortality. The overall 1-, 5-year, 10-year, and 15-year survival rates were 97.2% (95% CI: 94.5–99.9%),80.3% (95% CI: 71.7–88.9%), 59.2% (95% CI: 43.5–75.5%) and 49.3% (95% CI: 27.2–71.4%), respectively. Conclusion: Patients undergoing redo isolated tricuspid valve surgery carry a high risk of early mortality. Satisfactory results are achievable with endoscopic tricuspid valve surgery and repair results in lower surgical mortality than replacement with acceptable residual tricuspid regurgitation.

Peer review status:ACCEPTED

13 Mar 2021Submitted to Journal of Cardiac Surgery
15 Mar 2021Submission Checks Completed
15 Mar 2021Assigned to Editor
19 Mar 2021Reviewer(s) Assigned
04 Apr 2021Review(s) Completed, Editorial Evaluation Pending
06 Apr 2021Editorial Decision: Revise Major
23 Apr 20211st Revision Received
23 Apr 2021Submission Checks Completed
23 Apr 2021Assigned to Editor
30 Apr 2021Reviewer(s) Assigned
09 May 2021Review(s) Completed, Editorial Evaluation Pending
24 May 2021Editorial Decision: Accept