Predictors of Survival After Triple Valve Surgery: A Single Center Analysis

Background

Triple valve surgery is a complex operation with high perioperative mortality. Limited data exist regarding the predictors of success associated with this surgery. We report our experience.

Methods

A total of 211 sequential patients underwent triple valve surgery at 1 hospital from November 2007 through July 2022. Baseline characteristics, operative details, and mortality outcomes were reviewed.

Results

Eighty-two (38.9%) were redo operations and 68 (32.2%) were urgent. Commonly, aortic (n = 194; 91.4%) and mitral (n = 140; 66.4%) valves were replaced, and the tricuspid valve (n = 189; 89.6%) repaired. Concomitant procedures were done in 28% of patients. Thirty-day mortality was 21 of 211 (9.95%). Kaplan-Meyer survival at 1 and 7 years was 86.0% (interquartile range, 79%-93%) and 64.0% (interquartile range, 55%-74%), respectively. On multivariate regression, end-stage renal disease (hazard ratio, 4.16; P = .003) was associated with mortality, and mitral valve replacement (hazard ratio, 0.44; P = .009) was associated with improved long-term survival.

Conclusions

Despite the high number of redo and concomitant procedures, we report a 30-day mortality rate under 10% and an 86% 1-year survival. In our series, mitral valve replacement conferred a long-term survival benefit.