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Outcome following isolated tricuspid valve replacement
A A Mangoni1, T G DiSalvo, G J Vlahakes
1Department of Medicine (Cardiology Division), Massachusetts General Hospital and Harvard Medical School, MA, Boston, USA.
Objectives:
The clinical outcome of isolated tricuspid valve replacement is not well defined because this procedure is usually performed concomitantly with other valve surgery.
Methods:
We retrospectively studied the short and long-term outcome of 15 consecutive patients (six men and nine women, aged 61+/-3 years) undergoing isolated tricuspid valve replacement from 1984 to 1996. The cause of valve dysfunction was rheumatic heart disease in 12 patients, healed endocarditis in two patients, and sarcoidosis in one patient. The tricuspid valve was stenotic in one patient, regurgitant in eight patients, and both stenotic and regurgitant in six patients. A St. Jude Medical prosthesis was placed in eight patients, Carpentier-Edwards in five patients, and Björk-Shiley and Starr-Edwards in one patient each.
Results:
The median survival was only 1.2 years. Three patients (20%) died < or =30 days after the surgery or before discharge, and six other patients (40%) died within 3 years of surgery. Anasarca was the only predictor of short-term mortality (P=0.03), while the predictors of long-term mortality were anemia (P=0.01), rheumatic heart disease (P=0.04), previous stroke (P=0.04), and previous mitral valve surgery (P=0.04).
Conclusions:
Isolated tricuspid valve replacement is characterized by a poor short and long-term outcome.