Abstract
Objectives : The aims of this study were to analyze early and
late outcomes of TVS and identify predictors of poor prognosis .
Methods: Single centre retrospective study with 108 patients
who underwent TVS between 2007 and 2016. Most of the patients were
female (74.1%), mean age of 65 years; 61,1% were in New York Heart
Association class III/IV, with a EuroSCORE II of 7.5%. Univariable and
Multivariable analyses were developed to identify predictors of
perioperative mortality and morbidity and long-term mortality.
Results: In-hospital mortality was 12%. Creatinine clearance
was an independent predictor of decreased perioperative mortality. This
group had 28.7% rate of major perioperative complications. Systolic
pulmonary pressure and obesity were predictors of early morbidity.
The 10-year mortality was 29.6%. The survival at 1, 5 and 10 years was
80%, 76% and 45%, respectively. Diabetes Mellitus was a risk factor
for long-term mortality and creatinine clearance was a predictor of
long-term survival. Need for re-operation was identified in 3.5% of the
patients.
Conclusions: Patients undergoing TVS have high surgical risk
making TVS an operation associated with high mortality and morbidity.
This research identifies Diabetes Mellitus, renal function, pulmonary
hypertension and obesity as the future challenges in TVS.