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Beating versus arrested heart isolated tricuspid valve surgery: An 11-year experience in the current era

Authors :
William Uhlrich
Rémi Buzzi
J.F. Obadia
Martin Connock
Jean Luc Fellahi
Matteo Pozzi
Matthias Jacquet-Lagrèze
Xavier Armoiry
Daniel Grinberg
Michele Flagiello
Hélène Thibault
Hôpital Louis Pradel [CHU - HCL]
Hospices Civils de Lyon (HCL)
University of Warwick [Coventry]
Matériaux, ingénierie et science [Villeurbanne] (MATEIS)
Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL)
Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon)
Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)
CarMeN, laboratoire
Université Claude Bernard Lyon 1 (UCBL)
Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)
Source :
Journal of Cardiac Surgery, Journal of Cardiac Surgery, Wiley, 2021, 36 (3), pp.1020-1027. ⟨10.1111/jocs.15390⟩, Journal of Cardiac Surgery, 2021, 36 (3), pp.1020-1027. ⟨10.1111/jocs.15390⟩
Publication Year :
2021
Publisher :
HAL CCSD, 2021.

Abstract

International audience; BACKGROUND AND AIM OF THE STUDY: Data about the beating heart (BH) technique for isolated tricuspid valve (TV) surgery compared to the arrested heart (AH) technique are sparse. We compared the outcomes of isolated TV surgery between BH and AH technique. METHODS: We performed an observational analysis of our database of isolated TV surgery. Patients were divided into two groups according to whether surgery was performed without (BH group) or with (AH group) aortic cross-clamping and cardioplegic arrest. The primary endpoint was survival to hospital discharge. Risk factors for in-hospital mortality were searched with multivariate analyses. We undertook further comparisons after propensity-score matching. RESULTS: From January 2007 to December 2017, we performed 82 isolated TV surgery (BH group, n = 47, 57.3%; AH group, n = 35, 42.7%). The mean age was 59.1 years, 56.1% were female. BH group patients were older (61.8 vs. 55.4 years; p = .035), had greater impaired renal function (glomerular filtration rate, 61.1 vs. 74.6 ml/min; p = .012), were more frequently operated for secondary TR (61.7 vs. 31.4%; p = .008), underwent more frequently a reoperation (53.2 vs. 28.6%; p = .042) and exhibited a higher surgical risk (EuroSCORE II, 3.92 vs. 2.50%; p = .013). In-hospital mortality was not different between both groups, either considering unmatched (BH = 10.6 vs. AH = 5.7%; OR = 1.96, 95% confidence interval [CI] = 0.36-10.77) or matched populations (BH = 10.6 vs. AH = 6.4%; OR = 1.89, 95% CI = 0.36-9.97). Age was the only predictor of in-hospital mortality. CONCLUSIONS: The BH technique showed comparable outcomes to the AH technique for isolated TV surgery despite a higher risk profile.

Details

Language :
English
ISSN :
08860440 and 15408191
Database :
OpenAIRE
Journal :
Journal of Cardiac Surgery, Journal of Cardiac Surgery, Wiley, 2021, 36 (3), pp.1020-1027. ⟨10.1111/jocs.15390⟩, Journal of Cardiac Surgery, 2021, 36 (3), pp.1020-1027. ⟨10.1111/jocs.15390⟩
Accession number :
edsair.doi.dedup.....9465040b6e8e8613e7cd02a9b8690b22