Retrospective study on the impact of different tricuspid valve replacement positions on mid-to long-term postoperative prognosis
YI Tian-yang
FAN Rui
WANG Wu-wei
CHEN Xin
ZHU Yi-fan
Abstract：Objective This study was designed to analyze the impact of different tricuspid valve replacement positions(anatomical vs.supra-annular)on postoperative right heart function recovery and long-term prognosis.Methods A retrospective analysis was conducted on 120 patients who underwent tricuspid valve replacement,divided into an anatomical position group(97 cases)and a supra-annular position group(23 cases).Preoperative baseline data,intraoperative surgical indicators,early postoperative complications,and long-term follow-up outcomes were compared between the two groups.Cox regression analysis was used to identify factors related to prognosis.Results There were no significant differences between the anatomical and supra-annular groups concerning operation duration(332.5 min vs.372.5 min),cardiopulmonary bypass(CPB)time(144.5 min vs.146.5 min),or aortic cross-clamp time(99.5 min vs.100.5 min)(P>0.05).Additionally,no statistically significant differences were found in postoperative arrhythmia,conduction block,low cardiac output syndrome(LCOS),acute kidney injury(AKI),mortality,new-onset dialysis,or pacemaker implantation between the groups(P>0.05).Univariate analysis indicated that BMI(HR=0.817,P=0.025),preoperative NYHA functional class(HR=2.192,P=0.019),operation duration(HR=1.005,P=0.004),and CPB time(HR=1.005,P=0.046)were significantly associated with prognosis.Conversely,gender,age,diabetes,ejection fraction(EF),and severity of tricuspid regurgitation did not show significant correlation with prognosis.Multivariate analysis revealed that operation duration(HR=1.005,P=0.101)did not demonstrate independent statistical significance after adjusting for other variables.Kaplan-Meier survival analysis showed no significant difference in overall survival between the two groups during the follow-up period(Log-rank test P>0.05),suggesting that tricuspid valve replacement position(anatomical vs.supra-annular)has a limited impact on long-term survival.Conclusion The choice of replacement positions have a limited impact on right heart function recovery and long-term survival.Although not reaching statistical significance,the supra-annular group showed a potential advantage over the anatomical group in managing postoperative tricuspid regurgitation.Preoperative cardiac functional status and surgical complexity have a greater influence on prognosis.
Keywords：Tricuspid valve replacementOrthotopic replacementSupra-annular replacementRight heart functionPrognosis
Publication Date：2026-01-25
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：6( 30-35 )