JUAN CRESTANELLO: Welcome to the Cardiovascular Surgery Series where I discuss the latest research in cardiovascular surgery from the Mayo Clinic. I am Dr. Juan Crestanello. I am a cardiac surgeon at the Mayo Clinic.

I will discuss today "Early right ventricular reverse remodeling predicts survival after isolated tricuspid valve surgery." We have studied 223 patients who underwent isolated tricuspid valve surgery at our institution. Sixty patients underwent repair, and 163 patients had replacement. Operative mortality was 2.7%.

We evaluated the long-term survival of repair and replacement. And adjusted survival was better for repair than for replacement. However, after adjusting for the baseline clinical characteristics, survival was not associated with the type of valve surgery.

Right ventricle dysfunction was present in 43% of the patients preoperatively. Patients with right ventricular dysfunction had worse long-term survival, suggesting that early surgery, before the development of right ventricular dysfunction, will result in improved outcomes.

Tricuspid valve surgery is associated with improvement on the right ventricular size immediately after surgery. Patients who had right ventricular reverse remodeling, defined as improvement on right ventricular volumes or on right ventricular function, early after surgery have a significant better long-term survival.

We conclude that isolated tricuspid valve surgery can be accomplished with very acceptable operative mortality. Survival is best on patients who had the surgery before the development of moderate or severe right ventricular dysfunction. In addition, patients who had right ventricular reverse remodeling after surgery have substantial better survival. Thank you for listening to the Mayo Clinic Cardiovascular Surgery Series.