Is Surgery the Best Approach for Isolated Severe Tricuspid Regurgitation?

A retrospective cohort study failed to demonstrate a survival benefit with surgical repair or replacement.

Surgery for patients with isolated symptomatic severe tricuspid regurgitation (TR) is performed infrequently, partly due to the weak data of its benefit (Class II recommendation; level of evidence, C). In a retrospective, single-site, cohort analysis, investigators identified 3276 patients with isolated severe TR by echocardiography and assessed their treatments and outcomes (mean ages: medically treated patients, 73; surgical patients, 61; women 54%).

Most patients (95%) were managed only medically. Surgery was performed in 171 patients — 143 patients receiving repair (84%) and 28 undergoing valve replacement (16%). For medically managed patients, 1- and 5-year mortality was 31% and 63%, respectively. Because patients undergoing surgery wer…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)