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Tricuspid valve replacement with mechanical prostheses: long-term results
Andrea Garatti1, Alberto Canziani, Eugenio Mossuto
1Department of Cardiovascular Disease, 'E. Malan', Cardiac Surgery Unit, Policlinico S. Donato Hospital, San Donato Milanese, Milan, Italy. agaratti@tiscali.it
The Journal of Heart Valve Disease
|April 8, 2010
Summary
Tricuspid valve replacement (TVR) has high mortality, with 10-year survival at 58%. Older age, liver congestion, and redo surgery significantly impact long-term outcomes for TVR patients.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Disease
- Surgical Outcomes
Background:
- Tricuspid valve replacement (TVR) historically presents high mortality and morbidity.
- Limited data exists on the long-term outcomes of TVR procedures.
- This study reviews institutional experience with TVR.
Purpose of the Study:
- To evaluate the long-term outcomes of tricuspid valve replacement (TVR).
- To identify predictors of mortality and reoperation after TVR.
Main Methods:
- A consecutive series of 43 patients undergoing TVR between 1990 and 2005 were reviewed.
- All patients received a mechanical prosthesis for TVR.
- Data collected included patient demographics, etiology, NYHA class, procedure type, and follow-up events.
Main Results:
- Overall operative mortality was 16%. Ten-year survival was 58%.
- Freedom from reoperation at 10 years was 74%, with reoperations mainly for tricuspid valve thrombosis.
- Older age, liver congestion, and redo surgery were identified as major determinants of long-term mortality.
Conclusions:
- TVR is associated with significant short- and long-term mortality compared to left-heart valve surgery.
- Timely referral and intervention before end-stage cardiac impairment may improve TVR outcomes.
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