Preoperative Predictors of Postoperative Pulmonary Complication Following Isolated Tricuspid Valve Surgery

Abstract

Background: Postoperative pulmonary complications (PPC) are the most frequently observed complications following cardiac surgery, leading to extended hospital stays and significant medical and economic burdens. Although surgical interventions for tricuspid valve disease are increasingly common, few risk factors for PPC in the context of tricuspid valve surgery have been identified. Uncovering these factors would have valuable clinical implications in terms of prognosis. Methods: We conducted a single-center retrospective study to evaluate preoperative factors associated with susceptibility to PPC in patients undergoing tricuspid valve surgery between 2018 to 2023. Independent predictors of PPC were identified using regression analysis. Results: Of the 147 patients included in the study, 29.9% (44 cases) experienced PPC. No statistically significant differences were observed in surgical procedures between the groups. Regression analysis identified smoking status (odds ratio [OR]: 7.69, p = 0.01), severity grade of tricuspid regurgitation (TR) (OR: 26.56, p < 0.01), recent respiratory infection (OR: 78.52, p < 0.01), and pulmonary hypertension (OR: 13.60, p < 0.01) as independent risk factors for PPC following tricuspid valve surgery. Conversely, the 6-minute walk distance (6MWD) (OR: 0.99, p = 0.01) and tricuspid annular plane systolic excursion (TAPSE) (OR: 0.61, p < 0.01) were identified as independent protective factors. Conclusion: The incidence of PPC following tricuspid valve surgery was determined to be 29.9%. The identified predictors—smoking status, severity of tricuspid regurgitation, recent respiratory infections, pulmonary hypertension, as well as protective factors like 6MWD and TAPSE—can offer valuable insights for optimizing the preoperative physiological conditions in patients undergoing tricuspid valve surgery.