Risk Factors Associated With Tricuspid Replacement For Tricuspid Regurgitation After Cardiac Surgery

Purpose:To retrospectively analyze risk factors associated with tricuspid replacement for tricuspid regurgitation after cardiac surgery, and evaluate the predictive effect of New Euro SCORE ? for Tricuspid Replacement.Methods: The data of 77 redo-TVR from 2004 to 2013 in Shanghai Chest Hospital were retrospectively reviewed. All the cases are divided into the death group and the survival group. Risk factors that are significant in univariate analysis are taken into the Logistic model to be comprehensively analyzed.Results: Eight of the 77 patients(10.4%) died after tricuspid valve replacement in hospital. Univariate analysis showed that NYHA class ?, right heart failure, pulmonary artery pressure(>58 mm Hg), total bilirubin(>50 umol/L), creatinine(>90 umol/L),urea(>12 mmol/L), uric acid(>560 umol/L), sinus rhythm are statistically significant for early postoperative death(P<0.05), cardiopulmonary bypass time(>200 min), protection fluid(>2500 m L), blocking time(>80 min) and smaller prosthesis during the operation are statistically significant(P<0.05). Multiariable Logistic regression model analysis showed that preoperative creatinine(> 90 umol/L), and without atrial fibrillation are the independent risk factors of tricuspid replacement for tricuspid regurgitation after cardiac surgery(P<0.05). Statistical results show that the difference of Euro SCORE between two groups was statistically significant.Conclusion: There are many risk factors associated with early postoperative death of tricuspid replacement for tricuspid regurgitation after cardiac surgery, it is important to pay special attention to the preoperative preparation, especially to the patients with abnormal renal function. And the New Euro SCORE ? can be a reliable system to predict the risk of such operation.