Isolated tricuspid valve surgery at a single centre: the 47-year Auckland experience, 1965-2011

OBJECTIVES: Isolated tricuspid valve surgery is not commonly performed with few studies and limited numbers published. We reviewed the characteristics and outcomes, including survival, reoperation rates and their predictors of different types of isolated tricuspid surgery. METHODS: Patients coded for isolated tricuspid valve surgery were identified from the Green Lane Hospital database. Relevant clinical characteristics were collected from both clinical and written clinical records. Mortality was checked against the national 'Births, Deaths and Marriages' database from the Ministry of Health. RESULTS: Seventy-two consecutive patients (48 ± 16 years; 71% women, body mass index 25 ± 6) underwent isolated tricuspid valve surgery from 1965 to 2011. Valve repair was performed in 53 and 47% had a valve replacement. The majority of these operations were performed in the last two decades. Early mortality within 30 days of operation was 7.9% for repair and 17.6% for replacement (P = 0.29). The 1-, 5-, 10- and 25-year survival rates were 83.8, 74.5, 63.6 and 32.8% for tricuspid repair and 81.8, 68.2, 61.4 and 15.2% for tricuspid replacement, respectively. Preoperative loop diuretic dose (P = 0.0120) and preoperative haemoglobin level (P = 0.0377) were independent predictors of survival for all isolated tricuspid surgery, while preoperative creatinine level (P = 0.04) independently predicted reoperation during the follow-up. CONCLUSIONS: Both isolated tricuspid replacement and repair were associated with significant but acceptable early and late mortality with no statistically significant difference in cumulative survival. Preoperative loop diuretic dose, haemoglobin and creatinine are individually associated with survival and/or reoperation after isolated tricuspid valve surgery.