Associations between valve repair and reduced operative mortality in 21 056 mitral/tricuspid double valve procedures

J. Scott Rankin, Vinod H. Thourani, Rakesh M. Suri, Xia He, Sean M. O'Brien, Christina M. Vassileva, Ashish S. Shah, Matthew Williams

Research output: Contribution to journalArticle

Abstract

Objectives: Repair of either the mitral (M) or tricuspid (T) valve in single valve surgery is associated with reduced operative mortality. It is unclear, however, how valve repair influences mortality in combined MT procedures. This topic was evaluated in the Society of Thoracic Surgeons database. Methods: From 1993 through 2007, 21 056 patients underwent concomitant MT valve surgery. Group I had M&T replacement (n = 1130), Group II had M repair and T replacement (n = 216), Group III had M replacement and T repair (n = 11 448) and Group IV had both M&T repair (n = 8262). Unadjusted operative mortalities (UOMs) and morbidities of Groups I-IV were assessed, and logistic regression analysis adjusted for differences in baseline patient profiles. Surgical outcomes were expressed as UOMs, and also adjusted odds ratios (ORs) for mortality. Results: Group IV was older with more coronary artery bypassgrafting and generally less comorbidity, and Group I had more endocarditis, mitral stenosis and reoperation. UOM values were: Group I = 16.8, Group II = 10.2, Group III = 10.3 and Group IV = 8.0%. In the multivariable model, factors influencing mortality included: age (per 5-year increase, OR = 1.15),renal failure with dialysis (OR = 3.22), emergency status (OR = 3.14), second or more reoperations (OR= 1.92) and later surgical date (OR = 0.63). Both M and T repair were independently associated with lower operative mortalities vs prosthetic valve replacement (OR = 0.83 and 0.60, respectively, P

Original languageEnglish (US)
Article numberezt077
Pages (from-to)472-477
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume44
Issue number3
DOIs
StatePublished - Sep 2013

Keywords

  • Mitral valve repair
  • Multiple valve surgery
  • Tricuspid valve repair

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

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    Rankin, J. S., Thourani, V. H., Suri, R. M., He, X., O'Brien, S. M., Vassileva, C. M., Shah, A. S., & Williams, M. (2013). Associations between valve repair and reduced operative mortality in 21 056 mitral/tricuspid double valve procedures. European Journal of Cardio-thoracic Surgery, 44(3), 472-477. [ezt077]. https://doi.org/10.1093/ejcts/ezt077