Cardiovascular Surgery and Interventions 2024, Vol 11, Num 2 Page(s): 095-101
Assessing in-hospital mortality in tricuspid valve surgery: A focus on the tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio

Mehmet Altunova, Tuğba Aktemur

Department of Cardiology, University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye

Keywords: Mortality, TAPSE/PASP, tricuspid valve surgery
Objectives: This study aimed to investigate the association between the tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio and in-hospital mortality in patients undergoing tricuspid valve replacement or repair.

Patients and methods: A retrospective evaluation was conducted with 302 consecutive patients (182 females, 120 males; mean age: 59.5±11.7 years) who underwent surgical intervention on the tricuspid valve at our tertiary center between January 2019 and January 2022. The final endpoint of the study was determined as in-hospital mortality. Patients were divided into two groups: those who developed in-hospital mortality and those who did not. Regression analyses were conducted to identify the independent variables.

Results: Forty-eight patients died in the hospital. Multivariate logistic regression analysis aimed at determining the predictors of in-hospital mortality identified age (p=0.023), TAPSE/PASP (p=0.024), and hospital stay duration (p<0.001) as independent determinants of in-hospital mortality. A receiver operating characteristic curve was plotted, and a cutoff value of 0.30 was determined using the Youden index (area under the curve=0.692, 95% confidence interval 0.609-0.774, p<0.001). This cutoff value could detect in-hospital mortality with a sensitivity of 66.8% and specificity of 68.7%.

Conclusion: The TAPSE/PASP ratio, a simple echocardiographic score, is associated with in-hospital mortality in patients undergoing tricuspid valve replacement or repair.

DOI : 10.5606/e-cvsi.2024.1649