SAN ANTONIO (January 28, 2024) — The Society of Thoracic Surgeons and the American Association for Thoracic Surgery released a late-breaking study on a new risk model for isolated tricuspid valve surgery at the 2024 Annual Meeting taking place January 27 - 29 in San Antonio.
The research, conducted on patients within the STS Adult Cardiac Surgery Database (ACSD) undergoing isolated TV repair or replacement between July 2017 and June 2023, involved a comprehensive examination of 13,587 cases. The primary endpoints for the study were operative mortality and major morbidity/mortality composite. The findings resulted in a new risk prediction model that not only enhances the existing portfolio, but also provides a valuable benchmark for current and future TV interventions.
Key Methodology and Findings:
- Population Demographics: The isolated TV study population consisted of 41.1% repairs and 58.9% replacements. The overall predicted risk of operative mortality was 5.6%, with similar risks for repairs (5.5%) and replacements (5.7%). The predicted risk of composite morbidity and mortality was 28.2% for repairs and 26.8% for replacements.
- Predictors of Outcomes: Lower albumin and higher Model for End-Stage Liver Disease scores emerged as novel predictors associated with worse outcomes, highlighting the significance of these factors in the risk assessment for isolated TV surgery.
- Comparison of Repair and Replacement: TV replacements were generally in younger patients with a higher prevalence of endocarditis compared to repairs. Observed mortality rates were lower in endocarditis cases for both repair (2.7% vs. 6.1%) and replacement (4.1% vs. 7.1%).
- Model Performance: The risk prediction model yielded a C-statistic of 0.81 for mortality and 0.76 for composite morbidity and mortality. The observed-to-expected calibration was excellent across all sub-cohorts and predicted risk decile groups.
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Founded in 1964, The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,700 cardiothoracic surgeons, researchers, and allied healthcare professionals worldwide who are dedicated to ensuring the best possible outcomes for surgeries of the heart, lung, and esophagus, as well as other surgical procedures within the chest. The Society’s mission is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.