Valvular & structural heart disease
Benefit of isolated surgical valve repair or replacement for functional tricuspid regurgitation and long-term outcomes stratified by the TRI-SCORE
Authors' conclusion
Higher survival rates were observed with repair than replacement and benefit of intervention declined as TRI-SCORE increased with no benefit of any type of surgery in the high TRI-SCORE category.
Study context
- Population
- Patients with severe isolated functional tricuspid regurgitation
- Participants
- 551 vs 1,217
- Exposure
- Isolated tricuspid valve surgery vs conservative management
- Surgeryn = 551
- Conservative managementn = 1,217reference
- Outcome
- Survival, overall and by TRI-SCORE category (low ≤3, intermediate 4-5, high ≥6)
- Follow-up
- Up to 10 years
Methodological detailsmulticentre (33 centres, 10 countries), consecutive patients, TRIGISTRY registry
- Multicentre (33 centres, 10 countries)
- Consecutive patients
- TRIGISTRY registry
Main finding
Survival
Hazard ratio
.97
95% CI .88-1.08
P = 0.57
By group
Surgeryvs Conservative management
HR .97 (95% CI .88-1.08); P = 0.57
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Surgery | Conservative management | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Survival by TRI-SCORE category (subgroup) · up to 10 yearsLow TRI-SCORE | 72% | 44% | .27 (.20-.37) | P < 0.0001 | |
| Survival by TRI-SCORE category (subgroup) · up to 10 yearsIntermediate TRI-SCORE | 36% | 37% | 1.17 (.98-1.40) | P = 0.09 | |
| Survival by TRI-SCORE category (subgroup) · up to 10 yearsHigh TRI-SCORE | 20% | 24% | 1.06 (.91-1.25) | P = 0.45 | |
| Survival by surgery type, low TRI-SCORE (subgroup) · up to 10 yearsRepairvs Conservative management84% vs 44% | .11 (.06-.19) | P < 0.0001 | |||
| Survival by surgery type, low TRI-SCORE (subgroup) · up to 10 yearsReplacementvs Conservative management61% vs 44% | .65 (.47-.90) | P = 0.009 | |||
| Survival by surgery type, intermediate TRI-SCORE (subgroup) · up to 10 yearsRepairvs Conservative management59% vs 37% | .49 (.35-.68) | P < 0.0001 | |||
| Survival by surgery type, intermediate TRI-SCORE (subgroup) · up to 10 yearsReplacementvs Conservative management25% vs 37%; possibly harmful | 1.43 (1.18–1.72) | P = 0.0002 | |||
| 0.050.21520Hazard ratio (log scale) |
Original publication
Benefit of isolated surgical valve repair or replacement for functional tricuspid regurgitation and long-term outcomes stratified by the TRI-SCORE. Eur Heart J. Published 30 August 2024. doi:10.
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