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The following is a summary of “Racial and Ethnic Variations in Patients Undergoing Mitral and Tricuspid Valve Surgery,” published in the August 2024 issue of Surgery by Winicki et al.
Previous studies exploring the relationship between race and ethnicity and outcomes after mitral valve (MV) surgery have yielded inconsistent results. This retrospective analysis sought to clarify the association between race/ethnicity and both the operative presentation and outcomes of patients undergoing MV and tricuspid valve (TV) surgeries. Researchers examined data from 5,984 patients (2,730 female, median age 63 years) who underwent MV (n = 4,534, 76%), TV (n = 474, 8%), or combined MV and TV (n = 976, 16%) surgeries within a statewide collaborative between 2012 and 2021. The study assessed the influence of race/ethnicity on preoperative characteristics, rates of MV and TV repairs, and postoperative outcomes across racial and ethnic groups, including White (n = 4,244, 71%), Black (n = 1,271, 21%), Hispanic (n = 144, 2%), Asian (n = 171, 3%), and mixed/other races (n = 154, 3%).
The analysis revealed that Black patients presented with a significantly higher Society of Thoracic Surgeons (STS) predicted risk of morbidity and mortality (24.5% vs. 13.1%; P < 0.001) and a greater burden of comorbidities compared to White patients. Additionally, Black and Hispanic patients were less likely to undergo elective procedures (White 71%, Black 55%, Hispanic 58%; P < 0.001). Degenerative MV disease was predominantly observed in White patients (White 62%, Black 41%, Hispanic 43%, Asian 51%, mixed/other 45%; P < 0.05), while rheumatic heart disease was more prevalent among non-White patients, with the highest rates seen in Asian (28%), Hispanic (26%), and mixed/other race (25%) groups, compared to Black (17%) and White (10%) patients (P < 0.05).
Importantly, after adjusting for confounding variables, including demographic factors and comorbid conditions, the rates of MV and TV repair and adverse postoperative outcomes, including mortality, showed no significant differences across racial and ethnic groups. These findings highlight the association between race/ethnicity and the severity of preoperative conditions and MV disease etiology, suggesting a need for improved strategies in the early detection and timely surgical referral for valvular heart disease, particularly among minority populations. This approach may help mitigate disparities and enhance surgical outcomes in diverse patient populations.
Source: sciencedirect.com/science/article/pii/S0022480424002786
