World J Surg Surg Res | Volume 6, Issue 1 | Research Article | Open Access

Outcomes of Transcatheter Tricuspid Valve Repair vs. Surgical Tricuspid Valve Replacement or Repair in Patients with Tricuspid Insufficiency

Wang X¹ , Ma Y¹ , Liu C¹ , Liu Z¹ , Fan X² , Guan G¹ , Pan S^{1 *#} , Wang J^{1 *#} and Zhang Y^{1 *#}

¹Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, China ²Department of Endocrinology, Shandong Provincial Hospital, Shandong First Medical University, China

^*Correspondance to: Shuo Pan 

Abstract

Background: Tricuspid regurgitation associated with high morbidity and mortality, but with few treatment options. This study aims to compare the demographics, complications and outcomes of Transcatheter Tricuspid Valve repair (TTVr) vs. Surgical Tricuspid Valve Replacement (STVR) or Surgical Tricuspid Valve repair (STVr) based on a real-world investigation of National Inpatient Sample (NIS) database. Methods and Results: From 2016 to 2018 of NIS database, a total of 92, 86 and 84 tricuspid insufficiency patients who underwent STVr, STVR and TTVr were selected, respectively. Mean ages of patients were 65.03 years (STVr), 65.19 years (STVR) and 71.00 years (TTVr), TTVr patients were significantly older than STVr (P<0.05). The mortality of patients who received STVr (8.7% vs. 1.2%) or STVR (3.5% vs. 1.2%) were higher compared to that of patients who treated with TTVr. The patients who underwent STVr or STVR were more likely suffered from perioperative complications including third-degree atrioventricular block (8.7% STVr vs. 1.2% TTVr, P=0.309; 38.4% STVR vs. 1.2% TTVr, P<0.05), respiratory failure (5.4% STVr vs. 1.2% TTVr, P=0.372; 15.1% STVR vs. 1.2% TTVr, P<0.05), respiratory complications (6.5% STVr vs. 1.2% TTVr, P=0.325; 19.8% STVR vs. 1.2% TTVr, P<0.05), acute kidney injury (40.2% STVr vs. 28.6% TTVr, P=0.405; 34.9% STVR vs. 28.6% TTVr, P=0.697) and fluid and electrolyte disorders (44.6% STVr vs. 21.4% TTVr, P=0.102; 50% STVR vs. 21.4% TTVr, P<0.05). Average cost of care was higher (USD$379994 STVr vs. USD$198396 TTVr, P<0.05; USD$470947 STVR vs.USD$198396 TTVr, P<0.05), and average length of hospital stay was longer (15.41 STVr vs. 9.57 days TTVr, P=0.267; 24.69 STVR vs. 9.57 days TTVr, P<0.05) for STVr or STVR compared to TTVr. Conclusion: TTVr is associated with lower mortality, periprocedural morbidity, and resource use compared to STVr or STVR. More research and clinical trials are required to help formulate evidence-based guidelines for the role of catheter-based management of tricuspid valve disease

Keywords:

Transcatheter tricuspid valve repair; Surgical tricuspid valve replacement; Surgical tricuspid valve repair; Tricuspid insufficiency

Citation:

Wang X, Ma Y, Liu C, Liu Z, Fan X, Guan G, et al. Outcomes of Transcatheter Tricuspid Valve Repair vs. Surgical Tricuspid Valve Replacement or Repair in Patients with Tricuspid Insufficiency. World J Surg Surgical Res. 2023; 6: 1437.