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Original research article
Sex-stratified analysis of national trends and outcomes in isolated tricuspid valve surgery
  1. Pranav Chandrashekar1,
  2. Erin Amanda Fender1,
  3. Chad J Zack1,
  4. Yogesh N V Reddy1,
  5. Courtney E Bennett1,2,
  6. Megha Prasad1,
  7. Mohammed A Al-Hijji1,
  8. John M Stulak3 and
  9. Virginia M Miller3,4
  1. 1 Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
  2. 2 Department of Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
  3. 3 Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA
  4. 4 Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Virginia M Miller; miller.virginia{at}


Objective Female sex is a known risk factor for cardiac surgery, and tricuspid valve (TV) disease is more common in women. There are few data on sex-stratified surgical outcomes for isolated TV surgery. An administrative database was used to compare acute in-hospital outcomes between men and women undergoing isolated TV surgery.

Methods Patients aged >18 who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample. Patients were excluded if they had congenital heart disease, endocarditis, or were undergoing concomitant cardiac surgeries except coronary bypass. Results were weighted to represent national averages. Sex-stratified analysis was performed using propensity score matching to compare in-hospital mortality, postoperative complications and hospital costs.

Results Over 10 years, women represented 58% of the 5005 TV surgeries performed. With propensity matching, hospital mortality (7.9% vs 7.7%; P=0.99) and median length of stay (11 vs 11 days; P=0.99) were similar between men and women. However, median hospital charges were higher for men ($166 000 vs $155 000; P=0.04).

Conclusion Isolated TV surgery is rare, but women more commonly undergo the procedure. In-hospital mortality was similar between men and women after propensity matching, but remains markedly high for both men and women in comparison to that reported for left-sided isolated valve surgery.

  • tricuspid valve disease
  • surgery-valve
  • epidemiology

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  • Contributors PC, EAF, CJZ: conception and design; acquisition, analysis and interpretation of data for the work; drafting and revision of the article. YNVR, CEB, MP, MAA: conception and design; analysis and interpretation of data for the work; revision of manuscript. JMS: critical revision of manuscript for intellectual content. VMM: conception and design; critical revision of manuscript for intellectual content; final approval of the manuscript. All authors contributed significantly to data collection, analysis and drafting of the manuscript, are in agreement to be accountable for all aspects of the work, and have read and approved the final article.

  • Funding This publication was made possible by NIH P50 AG044170 and by CTSA (grant number UL1 TR000135) from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement No additional data are available.

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