Deviations From the Ideal Plasma Volume and Isolated Tricuspid Valve Surgery-Paving the Way for New Risk Stratification Parameters

Ena Hasimbegovic; Marco Russo; Martin Andreas; Paul Werner; Iuliana Coti; Dominik Wiedemann; Alfred Kocher; Günther Laufer; Benedikt S Hofer; Markus Mach

doi:10.3389/fcvm.2022.849972

Deviations From the Ideal Plasma Volume and Isolated Tricuspid Valve Surgery-Paving the Way for New Risk Stratification Parameters

Front Cardiovasc Med. 2022 Mar 25:9:849972. doi: 10.3389/fcvm.2022.849972. eCollection 2022.

Authors

Affiliations

¹ Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
² Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
³ Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

Abstract

Background: Congestion and plasma volume expansion are important features of heart failure, whose prognostic significance has been investigated in a range of surgical and non-surgical settings. The aim of this study was to evaluate the value of the estimated plasma volume status (ePVS) in patients undergoing isolated tricuspid valve surgery.

Methods: This study included patients who underwent isolated tricuspid valve surgery at the Vienna General Hospital (Austria) between July 2008 and November 2018. The PVS cut-off was calculated using ROC analysis and Youden's Index.

Results: Eighty eight patients (median age: 58 [IQR: 35-70] years; 44.3% male; 75.6% NYHA III/IV; median EuroSCORE II 2.65 [IQR: 1.70-5.10]; 33.0% endocarditis-related regurgitation; 60.2% isolated repair; 39.8% isolated replacement) were included in this study. Patients who died within 1 year following surgery had significantly higher baseline ePVS values than survivors (median ePVS 5.29 [IQR: -1.55-13.55] vs. -3.68 [IQR: -10.92-4.22]; p = 0.005). During a median actuarial follow-up of 3.02 (IQR: 0.36-6.80) years, patients with a preoperative ePVS ≥ -4.17 had a significantly increased mortality (log-rank p = 0.006).

Conclusions: ePVS is an easily obtainable risk parameter for patients undergoing isolated tricuspid valve surgery capable of predicting mid- and long-term outcomes after isolated tricuspid valve surgery.

Keywords: congestion; isolated tricuspid valve surgery; mortality; plasma volume status; tricuspid valve.