Limitations
In addition to this being a single-center, retrospective study, there
are several other limitations. The first is the wide heterogeneity of
patient surgical data between the subgroups because of the variance in
practice patterns from surgeon to surgeon and our team preferring to
perform TVr using endoscopic approach. Second, objective assessments of
tricuspid valve and right heart function are currently not available.
Third, the updated surgery
techniques began in 2015, the follow-up time was short. Long-term
outcomes are needed to confirm its durability. Despite all these
drawbacks, to our knowledge, the present study includes one of the
largest population of patients undergoing RITS with mid-to-long term
outcomes.