BACKGROUND Severe isolated disease of the tricuspid valve (TV) is increasing and results in intractable right heart failure. However, isolated TV surgery is rarely performed, and there are little data describing surgical outcomes. OBJECTIVES The purpose of this study was to evaluate contemporary utilization trends and in-hospital outcomes for isolated TV surgery in the United States. METHODS Patients age >18 years who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients with congenital heart disease, with endocarditis, and undergoing concomitant cardiac operations except for coronary bypass surgery were excluded. RESULTS Over a 10-year period, a total of 5,005 isolated TV operations were performed nationally. Operations per year increased from 290 in 2004 to 780 in 2013 (p < 0.001 for trend). In-hospital mortality was 8.8% and did not vary across the study period. Adjusted in-hospital mortality for TV replacement was significantly higher than TV repair (odds ratio: 1.91; 95% confidence interval: 1.18 to 3.09; p = 0.009). CONCLUSIONS Isolated TV surgery is rarely performed, although utilization has increased over time. However, despite an increase in surgical volume, operative mortality has not changed. Mortality is greatest in patients undergoing valve replacement. Given the increasing prevalence of isolated TV disease in the population, research into optimal surgical timing and patient selection is critical.

中文翻译：

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孤立性三尖瓣手术的全国趋势和结果

背景三尖瓣（TV）的严重孤立性疾病正在增加并导致顽固性右心衰竭。然而，很少进行单独的电视手术，并且几乎没有描述手术结果的数据。目的 本研究的目的是评估美国隔离电视手术的当代使用趋势和院内结果。方法 使用全国住院患者样本确定 2004 年至 2013 年接受电视维修或更换的年龄 >18 岁的患者。排除患有先天性心脏病、心内膜炎和接受除冠状动脉搭桥手术以外的伴随心脏手术的患者。结果 10 年间，全国共进行了 5,005 次独立电视操作。每年的运营从 2004 年的 290 次增加到 2013 年的 780 次（p < 0. 001 表示趋势）。住院死亡率为 8.8%，并且在整个研究期间没有变化。TV 置换调整后的院内死亡率显着高于 TV 修复（比值比：1.91；95% 置信区间：1.18 至 3.09；p = 0.009）。结论 孤立电视手术很少进行，尽管随着时间的推移使用率有所增加。然而，尽管手术量增加，但手术死亡率并没有改变。接受瓣膜置换术的患者死亡率最高。鉴于人群中孤立性 TV 疾病的患病率不断增加，研究最佳手术时机和患者选择至关重要。95% 置信区间：1.18 到 3.09；p = 0.009）。结论 孤立电视手术很少进行，尽管随着时间的推移使用率有所增加。然而，尽管手术量增加，但手术死亡率并没有改变。接受瓣膜置换术的患者死亡率最高。鉴于人群中孤立性 TV 疾病的患病率不断增加，研究最佳手术时机和患者选择至关重要。95% 置信区间：1.18 到 3.09；p = 0.009）。结论 孤立电视手术很少进行，尽管随着时间的推移使用率有所增加。然而，尽管手术量增加，但手术死亡率并没有改变。接受瓣膜置换术的患者死亡率最高。鉴于人群中孤立性 TV 疾病的患病率不断增加，研究最佳手术时机和患者选择至关重要。