Valvular & structural heart diseaseCohort study
Benefit of isolated surgical valve repair or replacement for functional tricuspid regurgitation and long-term outcomes stratified by the TRI-SCORE
- International cohort study
- multicentre (33 centres, 10 countries)
- consecutive patients
- TRIGISTRY registry
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
Main finding
Survival
Hazard ratio
.97
95% CI .88-1.08
P = 0.57
By group
As reported in the abstract
Observational data: associations, not effects.
Further findings
Survival by TRI-SCORE category (subgroup) · up to 10 years · low TRI-SCORE
HR .27 (.20-.37) · P < 0.0001
Survival by TRI-SCORE category (subgroup) · up to 10 years · intermediate TRI-SCORE
HR 1.17 (.98-1.40) · P = 0.09
Survival by TRI-SCORE category (subgroup) · up to 10 years · high TRI-SCORE
HR 1.06 (.91-1.25) · P = 0.45
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Survival by surgery type, intermediate TRI-SCORE (subgroup) · up to 10 years — Replacement vs Conservative management · 25% vs 37%; possibly harmful | 1.43 (1.18–1.72) | P = 0.0002 | |
| 0.512Hazard ratio (log scale) |
| Outcome | HR (95% CI) | P value |
|---|---|---|
| Survival by surgery type, low TRI-SCORE (subgroup) · up to 10 years — Repair vs Conservative management · 84% vs 44% | .11 (.06-.19) | P < 0.0001 |
| Survival by surgery type, low TRI-SCORE (subgroup) · up to 10 years — Replacement vs Conservative management · 61% vs 44% | .65 (.47-.90) | P = 0.009 |
| Survival by surgery type, intermediate TRI-SCORE (subgroup) · up to 10 years — Repair vs Conservative management · 59% vs 37% | .49 (.35-.68) | P < 0.0001 |
Original publication
Summarised from the published abstract; every number is checked against it