Does Triscore Predict The Outcomes Of Endoscopic Minimal Invasive Isolated Tricuspid Valvular Disease?
Yung-Szu Wu1, Ravi Ghatnatti2, Joseph Zacharias2.
1Taichung Veterans General Hospital, Taichung, Taiwan, 2Blackpool Victoria Hospital, Blackpool, United Kingdom.
BACKGROUND: Isolated tricuspid valve disease is operated on less frequently than left side valvular disease. These patients have surgical intervention after right heart failure signs could not be controlled by medical treatment. TRI-SCORE is a new risk score for predicting mortality after isolated tricuspid valve surgery. This score has not been validated in minimal invasive cardiac surgery. We would like to know whether TRI-score could be a useful tool to predict the outcomes of minimal invasive cardiac surgery for isolated tricuspid valve disease including redo cases.
METHODS: In this retrospective study, we have collected data from patients had isolated tricuspid valve surgery from 2008 to 2022 Oct in our center. We exclude patients underwent sternotomy or had combined procedures. In primary analysis, the short-term outcomes include intraoperative bypass time, blood loss volume, postoperative complications, durations of hospital stay and in-hospital mortality. Long-term outcome is all-cause mortality rate after operation.
RESULTS: A total of 22 patients had minimal invasive cardiac surgery to treat isolated tricuspid valvular disease. The average point of TRI-score is 2.91±2.09 and the average EuroSCORE is 10.66±7.05%. The average age of patients is 64.8±13.6 years old, 13 patients (59.09%) have previous cardiac surgeries. Intraoperative data reveals the average cross-clamping time is 68.4±46.4 mins and bypass time is 139.5 48.2 mins. Blood loss volume in average is 385±403ml. No patient needs new permanent pacemaker during hospitalization. The average duration of ICU-stay is 4.3±10.2 days and post-operative stay is 16.41±19.72 days. In-hospital mortality rate of patients is 9.09% (2 patients). The average follow-up duration is 70.27±49.91 months. The 3-month and 5-year survival rate is 90.91% and 86.36%.
CONCLUSIONS: According to our limited data, the TRI Score is better than EuroSCORE at predicting the risk of mortality even in minimally invasive tricuspid valve surgery. Both patients with in-hospital mortality had a TRI-score above 4 points. Therefore, it is validated that TRI-score can predict the outcome of minimal invasive cardiac surgery for isolated tricuspid valvular disease. We would recommend early surgery in patients with low TRI-score and look forward to validating this in a multicenter cohort soon.
| Patients number | 22 | |
| Age | 64.82 | ±13.64 |
| TRIscore | 2.91 | ±2.09 |
| EuroSCORE (%) | 10.66 | ±7.04 |
| Previous cardiacsurgbery | 13 | 59.09% |
| Cross-clamp time (min) | 68.41 | ±46.41 |
| Blood loss volume(ml) | 385.00 | ±403.16 |
| Follow up duration (month) | 70.27 | ±49.91 |
| In-hospital mortality | 2 | 9.09% |
| 5-year mortality | 3 | 13.64% |
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