Results of tricuspid valve replacement for nonrheumatic and noninfective disease

Because of the rarity of isolated, nonrheumatic, noninfective tricuspid valvular disease, the long-term results of treatment by tricuspid valve replacement are uncertain. From June 1967 to April 1986, we implanted 23 biological or mechanical tricuspid valve prostheses in 20 patients for nonrheumatic, noninfective endocarditis. All cases were followed from 1 to 20 years after the procedure, for a total of 215.08 patient-years. There were 2 hospital deaths and 3 late deaths. Actuarial analysis indicated a mortality rate of 1.39% + 1.6% per year. Late morbidity included 3 episodes of prosthetic thrombosis in 2 patients, arrhythmias in 5 patients, and recurrent spontaneous abortions in 1 patient. New York Heart Association Functional Class improved in all survivors. We conclude that tricuspid valve replacement, especially when a bioprosthesis is used, can be performed with a low operative risk and good long-term results in patients who have nonrheumatic, noninfective, valvular disease.