Skip to main content
Journal cover image

The expanding role of mitral valve repair in triple valve operations: contemporary North American outcomes in 8,021 patients.

Publication ,  Journal Article
Suri, RM; Thourani, VH; Englum, BR; Rankin, JS; Badhwar, V; Svensson, LG; Ailawadi, G; Mack, MJ; He, M; Brennan, JM; Schaff, HV; Gammie, JS
Published in: Ann Thorac Surg
May 2014

BACKGROUND: Although the operative risk of multivalve operations has historically been high, current outcomes are poorly understood. We sought to evaluate factors influencing contemporary results of triple-valve operations using The Society of Thoracic Surgeons Adult Cardiac Surgery Database. METHODS: Among patients undergoing combined mitral, aortic, and tricuspid valve (triple- valve) operations between 1993 and 2011, aortic valve repair patients were excluded and those having aortic valve replacement were analyzed according to whether they underwent repair vs replacement of the mitral valve (MV) and tricuspid valve (TV). Temporal trends in operative death and clinical outcomes were examined using unadjusted and adjusted analyses. RESULTS: A total of 8,021 triple-valve patients were studied. The median (25th percentile, 75th percentile) age was 67 years (59, 77 years), 4,809 (60%) were women, 4,488 (56%) had New York Heart Association class III to IV symptoms, and the mean (25th percentile, 75th percentile) ejection fraction was 50% (40%, 60%). MV repair was performed in 2,728 (34%) patients overall and increased over time from 13% (1993 to 1997) to 41% (2008 to 2011). TV repair was performed in 7,512 (94%) patients overall and increased over time from 86% (1993 to 1997) to 96% (2008 to 2011). Unadjusted operative mortality decreased from 17% in 1993 to 9% in 2011. Adjusted odds ratios (95% confidence intervals) of operative mortality were lower in those having MV repair (0.72 [0.61 to 0.85]), TV repair (0.64 [0.50 to 0.83]), and MV+TV repair (0.46 [0.34 to 0.63]) compared with those having replacements. Unadjusted and adjusted odds of stroke were similar between groups and not significant for all. CONCLUSIONS: This large series demonstrates that surgical results of triple-valve operations have continued to improve during the past 18 years. MV and TV repair were associated with improvements in early survival. Although further study is required to understand late outcomes, these data suggest that broader efforts to perform MV repair instead of replacement in this high-risk patient population appear warranted.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2014

Volume

97

Issue

5

Start / End Page

1513 / 1519

Location

Netherlands

Related Subject Headings

  • Tricuspid Valve
  • Treatment Outcome
  • Survival Analysis
  • Societies, Medical
  • Sex Factors
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • North America
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Suri, R. M., Thourani, V. H., Englum, B. R., Rankin, J. S., Badhwar, V., Svensson, L. G., … Gammie, J. S. (2014). The expanding role of mitral valve repair in triple valve operations: contemporary North American outcomes in 8,021 patients. Ann Thorac Surg, 97(5), 1513–1519. https://doi.org/10.1016/j.athoracsur.2014.02.025
Suri, Rakesh M., Vinod H. Thourani, Brian R. Englum, J Scott Rankin, Vinay Badhwar, Lars G. Svensson, Gorav Ailawadi, et al. “The expanding role of mitral valve repair in triple valve operations: contemporary North American outcomes in 8,021 patients.Ann Thorac Surg 97, no. 5 (May 2014): 1513–19. https://doi.org/10.1016/j.athoracsur.2014.02.025.
Suri RM, Thourani VH, Englum BR, Rankin JS, Badhwar V, Svensson LG, et al. The expanding role of mitral valve repair in triple valve operations: contemporary North American outcomes in 8,021 patients. Ann Thorac Surg. 2014 May;97(5):1513–9.
Suri, Rakesh M., et al. “The expanding role of mitral valve repair in triple valve operations: contemporary North American outcomes in 8,021 patients.Ann Thorac Surg, vol. 97, no. 5, May 2014, pp. 1513–19. Pubmed, doi:10.1016/j.athoracsur.2014.02.025.
Suri RM, Thourani VH, Englum BR, Rankin JS, Badhwar V, Svensson LG, Ailawadi G, Mack MJ, He M, Brennan JM, Schaff HV, Gammie JS. The expanding role of mitral valve repair in triple valve operations: contemporary North American outcomes in 8,021 patients. Ann Thorac Surg. 2014 May;97(5):1513–1519.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

May 2014

Volume

97

Issue

5

Start / End Page

1513 / 1519

Location

Netherlands

Related Subject Headings

  • Tricuspid Valve
  • Treatment Outcome
  • Survival Analysis
  • Societies, Medical
  • Sex Factors
  • Risk Assessment
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • North America