Imaging and haemodynamic parameters associated with clinical outcomes following isolated tricuspid valve surgery

Essa Hariri, Habib Layoun, Jonathan Hansen, Ossama Abou Hassan, Joseph Kassab, Nicholas Kassis, Paul C. Cremer, Mazen Hanna, Amgad Mentias, Scott D. Flamm, Remy Daou, Brian Griffin, Haytham Elgharably, Shinya Unai, Gosta Pettersson, Samir Kapadia, Serge C. Harb*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Introduction Isolated tricuspid valve surgery (TVS) may be associated with high morbidity and mortality. The aim of this study was to investigate the association of preoperative imaging and haemodynamic data derived from echocardiography (ECHO), cardiac magnetic resonance (CMR) and right heart catheterisation (RHC) with postoperative outcomes following TVS. Methods In a retrospective cohort study, patients who underwent isolated TVS at our institution between 2012 and 2020 were screened and followed up to 1 year. We only included those who had all three tests before surgery: ECHO, CMR and RHC. Patients with congenital heart disease, infective endocarditis and those who underwent concomitant valve or pericardial surgery were excluded. The primary outcome was a composite of mortality and congestive heart failure at 1 year. Time-to-event analyses at 1 year and Cox proportional hazards regression analyses were performed. Results A total of 60 patients were included (mean age of 60±14 years, 63% women), of whom 67% underwent TV repair. The primary outcome occurred in 16 patients (27%) with a 1-year mortality of 7%. It was associated with ECHO-derived right ventricular (RV) free wall strain and RHC-derived RV systolic and diastolic as well as mean pulmonary pressures. On multivariable Cox regression analysis, only RV systolic and diastolic pressures were significantly associated with the primary outcome at 1 year (HRs=5.9 and 3.4, respectively, p<0.05). Conclusion Baseline invasive haemodynamic assessment could have a strong association with clinical outcomes and help risk-stratify patients undergoing isolated TVS.

Original languageEnglish (US)
Article numbere002124
JournalOpen Heart
Volume9
Issue number2
DOIs
StatePublished - Dec 15 2022

Keywords

  • Cardiac Catheterization
  • Echocardiography
  • Heart Failure, Systolic
  • Magnetic Resonance Imaging
  • Tricuspid Valve Insufficiency

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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