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Valvular heart disease
Original research
Predictive value of the TRI-SCORE for in-hospital mortality after redo isolated tricuspid valve surgery
  1. Julien Dreyfus1,
  2. Yohann Bohbot2,
  3. Augustin Coisne3,
  4. Yoan Lavie-Badie4,
  5. Michele Flagiello5,
  6. Baptiste Bazire6,
  7. Florian Eggenspieler7,
  8. Florence Viau8,
  9. Elisabeth Riant1,9,
  10. Yannick Mbaki10,
  11. Damien Eyharts4,
  12. Thomas Sénage11,
  13. Thomas Modine12,
  14. Martin Nicol1,
  15. Fabien Doguet13,
  16. Thierry Le Tourneau14,
  17. Christophe Tribouilloy2,
  18. Erwan Donal10,
  19. Jacques Tomasi15,
  20. Gilbert Habib8,
  21. Christine Selton-Suty7,
  22. Costin Radu9,
  23. Pascal Lim9,
  24. Richard Raffoul6,
  25. Bernard Iung6,
  26. Jean-Francois Obadia5,
  27. Etienne Audureau9,
  28. David Messika-Zeitoun16
  1. 1 Cardiology Department, Centre Cardiologique du Nord, Saint Denis, France
  2. 2 Cardiology Department, University Hospital Centre Amiens-Picardie South Site, Amiens, France
  3. 3 Department of Echocardiography and Cardiovascular Explorations, Centre Hospitalier Regional Universitaire de Lille, Lille, France
  4. 4 Cardiology Department, University Hospital Centre Toulouse, Toulouse, France
  5. 5 Department of Cardiovascular Surgery and Transplantation, Hopital Cardio-Vasculaire et Pneumologique Louis Pradel, Lyon, France
  6. 6 Cardiology Department, Bichat - Claude-Bernard Hospital Cardiology Service, Paris, France
  7. 7 Cardiology Department, University Hospital Centre Nancy, Nancy, France
  8. 8 Cardiology Department, Hôpital de la Timone, Marseille, France
  9. 9 Cardiology Department, Hospital Henri Mondor, Creteil, France
  10. 10 Cardiology Department, University Hospital Centre Rennes, Rennes, France
  11. 11 Cardiac Surgery Department, University Hospital Centre Nantes, Nantes, France
  12. 12 Cardiac Surgery Department, Centre Hospitalier Regional Universitaire de Lille, Lille, France
  13. 13 Cardiac Surgery Department, University Hospital Centre Rouen, Rouen, France
  14. 14 Cardiology Department, University Hospital Centre Nantes, Nantes, France
  15. 15 Cardiac Surgery Department, University Hospital Centre Rennes, Rennes, France
  16. 16 Cardiology Department, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
  1. Correspondence to Dr Julien Dreyfus, Cardiology Department, Centre Cardiologique du Nord, Saint Denis 93200, France; dreyfusjulien{at}yahoo.fr

Abstract

Objectives The TRI-SCORE reliably predicts in-hospital mortality after isolated tricuspid valve surgery (ITVS) on native valve but has not been tested in the setting of redo interventions. We aimed to evaluate the predictive value of the TRI-SCORE for in-hospital mortality in patients with redo ITVS and to compare its accuracy with conventional surgical risk scores.

Methods Using a mandatory administrative database, we identified all consecutive adult patients who underwent a redo ITVS at 12 French tertiary centres between 2007 and 2017. Baseline characteristics and outcomes were collected from chart review and surgical scores were calculated.

Results We identified 70 patients who underwent a redo ITVS (54±15 years, 63% female). Prior intervention was a tricuspid valve repair in 51% and a replacement in 49%, and was combined with another surgery in 41%. A tricuspid valve replacement was performed in all patients for the redo surgery. Overall, in-hospital mortality and major postoperative complication rates were 10% and 34%, respectively. The TRI-SCORE was the only surgical risk score associated with in-hospital mortality (p=0.005). The area under the receiver operating characteristic curve for the TRI-SCORE was 0.83, much higher than for the logistic EuroSCORE (0.58) or EuroSCORE II (0.61). The TRI-SCORE was also associated with major postoperative complication rates and survival free of readmissions for heart failure.

Conclusion Redo ITVS was rarely performed and was associated with an overall high in-hospital mortality and morbidity, but hiding important individual disparities. The TRI-SCORE accurately predicted in-hospital mortality after redo ITVS and may guide clinical decision-making process (www.tri-score.com).

  • tricuspid valve insufficiency

Data availability statement

Data are available upon reasonable request. Data sharing with qualified researchers may be considered after submission of a proposal to JD.

https://doi.org/10.1136/heartjnl-2022-322167

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    Data availability statement

    Data are available upon reasonable request. Data sharing with qualified researchers may be considered after submission of a proposal to JD.

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    Footnotes

    • Twitter @juliendreyfus1, @AugustinCoisne, @Gilbert HABIB, @none

    • JD and YB contributed equally.

    • Presented at The study was presented at the European Society of Cardiology Congress 2022, PCR London Valves 2022 and European Days of the French Society of Cardiology Conference 2023.

    • Contributors JD and DM-Z contributed to the study conception and design. Material preparation and data collection were performed by all authors. Analysis was performed by JD, YB, EA and DM-Z. The first draft of the manuscript was written by JD, YB and DM-Z. All authors read and commented on previous versions of the manuscript and approved the final manuscript. JD is guarantor of the overall study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests TM received consultant fees from Abbott, Edwards and Medtronic. BI received consultant fees from Edwards. J-FO received consultant fees from Abbott, Carmat, Delacroix-Chevalier, Landanger, Medtronic and Sorin. DM-Z received consultant fees and research grants from Edwards. Other authors have no relationship to declare.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.