Key result
Endocarditis in isolated tricuspid valve surgery was associated with similar 30-day mortality (2.8% vs 6.8%; OR 0.45) but significantly higher cumulative incidence of cardiac death (p=0.01).
Why the study?
The role of the underlying etiology in isolated tricuspid valve surgery has not been investigated extensively in current literature.
Does isolated tricuspid valve surgery for endocarditis have worse outcomes compared to surgery for other pathologies in adult patients?
Cohort (n=406)
Yes
Does isolated tricuspid valve surgery for endocarditis have worse outcomes compared to surgery for other pathologies in adult patients?
Odds Ratio: 0.45
Absolute Event Rate: 2.8% vs 6.8%
Isolated tricuspid valve surgery for endocarditis has acceptable 30-day mortality but is associated with significantly reduced late survival compared to surgery for other etiologies.
Acceptable short-term mortality supports surgery in selected endocarditis cases; leaves open etiology-specific strategies to reduce late cardiac death.
OBJECTIVES: The role of the underlying etiology in isolated tricuspid valve surgery has not been investigated extensively in current literature. Aim of this study was to analyse outcomes of patients undergoing surgery due to endocarditis compared to other pathologies. METHODS: The SURTRI study is a multicenter study enrolling adult patients who underwent isolated tricuspid valve surgery (n = 406, 55 ± 16 y.o.; 56% female) at 13 international sites. Propensity weighted analysis was performed to compare groups (IE group n = 107 vs Not-IE group n = 299). RESULTS: No difference was found regarding the 30-day mortality (Group IE: 2.8% vs Group Not-IE = 6.8%; OR = 0.45) and major adverse events. Weighted cumulative incidence of cardiac death was significantly higher for patients with endocarditis (p = 0.01). The composite endpoint of cardiac death and reoperation at 6 years was reduced in the Group IE (63.2 ± 6.8% vs 78.9 ± 3.1%; p = 0.022). Repair strategy resulted in an increased late survival even in IE cases. CONCLUSIONS: Data from SURTRI study report acceptable 30-day results but significantly reduced late survival in the setting of endocarditis of the tricuspid valve. Multi-disciplinary approach, repair strategy and earlier treatment may improve outcomes.
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Mauro et al. (2022) conducted a cohort in Isolated tricuspid valve disease (n=406). Endocarditis (IE) vs. Other pathologies (Not-IE) was evaluated on 30-day mortality (OR 0.45). Endocarditis in isolated tricuspid valve surgery was associated with similar 30-day mortality (2.8% vs 6.8%; OR 0.45) but significantly higher cumulative incidence of cardiac death (p=0.01).
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