Key result
Pediatric TV surgery for non-Ebstein disease is linked to ~20% midterm reintervention or ≥moderate TR.
Why the study?
Tricuspid valve surgery remains understudied, with little data describing surgical indications, outcomes, and prognostic factors for pediatric patients with non-Ebstein 2-ventricle congenital tricuspid valve lesions.
What are the outcomes and risk factors for reintervention or recurrent TR following isolated tricuspid valve surgery in pediatric patients with non-Ebstein 2-ventricle congenital TV disease?
Cohort
No
What are the outcomes and risk factors for reintervention or recurrent TR following isolated tricuspid valve surgery in pediatric patients with non-Ebstein 2-ventricle congenital TV disease?
p-value: p== .01
Tricuspid valve surgery in pediatric patients with non-Ebstein congenital TV disease yields good outcomes, with a 20% rate of midterm reintervention or moderate/severe TR, driven by younger age (<12 years) and preoperative mitral regurgitation.
Supports vigilant follow-up after pediatric TV surgery, especially in younger patients; leaves open optimal timing and technique in non-Ebstein disease.
Objectives: Tricuspid valve (TV) surgery remains understudied and little data exist describing the surgical indications, outcomes, and prognostic factors for pediatric patients with non-Ebstein 2-ventricle congenital TV lesions. This study aims to describe early and late outcomes of pediatric patients with non-Ebstein congenital TV lesions undergoing isolated TV procedures at a single institution. Methods: All patients who underwent TV surgery for non-Ebstein congenital TV disease between 2006 and 2018 were included. Patients who had missing preoperative data, patients with single-ventricle physiology, congenitally corrected transposition of the great arteries, and patients undergoing TV intervention as part of repair of an atrioventricular canal defect were excluded. The primary end point was the occurrence of TV reintervention or TV regurgitation (TR) ≥ moderate. Results: = .01) were independent risk factors for TV reintervention or recurrent TR deemed to be moderate or greater at last follow-up. Conclusions: TV surgery in patients with non-Ebstein congenital TV disease can be performed with good outcomes. TV reintervention or TR deemed moderate or greater occurred in 20% of patients on midterm follow-up. Patients younger than age 12 years are at higher risk for recurrent TR or TV reintervention, whereas preoperative MR deemed moderate or greater increases this risk, especially in patients older than age 12 years. There was no difference in outcomes between TV replacement and repair.
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Blitzer et al. (2022) conducted a cohort in non-Ebstein 2-ventricle congenital tricuspid valve diseases. Tricuspid valve surgery was evaluated on occurrence of TV reintervention or TV regurgitation (TR) ≥ moderate (p== .01). Tricuspid valve surgery in pediatric patients with non-Ebstein congenital disease resulted in TV reintervention or ≥moderate TR in 20% of patients at midterm follow-up.
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