Thorac Cardiovasc Surg 2017; 65(03): 174-181
DOI: 10.1055/s-0036-1584571
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Preoperative Predictors and Outcome of Triple Valve Surgery in 487 Consecutive Patients

Thilo Noack
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Fabian Emrich
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Philipp Kiefer
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Alexandro Hoyer
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
David Michael Holzhey
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Piroze Davierwala
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Martin Misfeld
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Farhad Bakhtiary
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Joerg Seeburger
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
,
Friedrich-Wilhelm Mohr
1  Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany
› Author Affiliations
Further Information

Publication History

16 November 2015

13 May 2016

Publication Date:
07 July 2016 (online)

Abstract

Background Triple valve surgery (TVS) is associated with an elevated risk for operative mortality and thus remains a surgical challenge. We report our experience and results of TVS procedures, especially with respect to identification of preoperative risk factors, to improve patient selection.

Methods Between December 1994 and January 2013, 487 consecutive patients (240 male, 247 female) underwent TVS at the Heart Center Leipzig, University of Leipzig. The data were prospectively collected and retrospectively analyzed. Univariate and multivariable regression analyses were performed to identify risk factors.

Results The 30-day mortality was 16.1% and the long-term survival at 1 year and 5 years was 71.8% and 54.6%, respectively. Multivariable logistic regression analysis identified previous myocardial infarction to be the only significant predictor for early mortality. Age, New York Heart Association functional class IV, previous myocardial infarction, dialysis, and liver dysfunction were identified as preoperative predictors for late mortality. Furthermore, an increase of operative risk, given for each year, was observed during the study period. In contrast, 30-day mortality decreased during the observation time.

Conclusion TVS is associated with a high surgical risk. Long-term survival is decreased, but acceptable for these high-risk patients. The series demonstrates that increasing surgical risk, age, and comorbidities are the future challenges in TVS.