Timing of Referral of Patients With Severe Isolated Tricuspid Valve Regurgitation to Surgeons (from a French Nationwide Database)
Section snippets
Methods
Since the 1991 law on health-care reform, all health-care institutions are mandated to analyze their own activity and transfer the information to the State and to the national health insurance. To achieve this, the PMSI database was created to collect data on patients' diagnoses, procedures, and in-hospital outcome. Each hospitalization is encoded in a standardized dataset which includes patient's information, length of stay, pathologies, and procedures. Diagnoses are coded using the 10th
Results
A total of 241 consecutive patients underwent an ITVS in France during the 2-year study period. Clinical characteristics of this population are presented in Table 1. Mean age was 61 ± 16 years and 128 patients (53%) were women. Eighty-seven patients (36%) had atrial fibrillation, 63 patients (26%) presented with congestive heart failure, and 51 (21%) had a previous left-sided heart valve surgery. TV surgery was performed because of infective endocarditis in 48 patients (20%). Most of the
Discussion
In this large contemporary and consecutive series, ITVS was (1) associated with a high (10%) mortality, (2) responsible for high morbidity with a 19% major complication rate and consequently a remarkably long in-hospital length of stay, and (3) preoperative clinical presentation was an important predictor of in-hospital death and major complication rates. Our results suggest that these patients are often referred too late and that an earlier intervention may improve immediate and possibly
Acknowledgment
We would like to specially thank all the team of HoxCom Analytiques for their help and support on this project.
Disclosures
None of the authors has conflict of interest or disclosure related to the present study.
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