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Mechanical valve replacement versus bioprosthetic valve replacement in the tricuspid valve position
Won-Chul Cho1, Chong Bin Park, Joon Bum Kim
1Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan, College of Medicine, Gangneung, Korea.
Background:
The purpose of this study was to evaluate the clinical outcomes and risk of tricuspid valve replacements and to compare bioprosthetic versus mechanical valves.
Methods:
Between 1991 and 2009, 104 consecutive patients (71 women; mean age, 57 ± 10.8 years) with tricuspid valvular disease underwent mechanical TVR (mechanical group; n = 59) or bioprosthetic TVR (bioprosthesis group; n = 45). Follow-up was complete in 97.1% (n = 101) with a median duration of 49.9 months (range 0-230 months).
Results:
Hospital mortality after mechanical TVR and bioprosthetic TVR was not different on adjusted analysis by propensity score. Ten-year actuarial survival after mechanical and bioprosthetic TVR was 83.9 ± 7.6% and 61.4 ± 9.1%, respectively (p = 0.004). However, there was also no significant difference in terms of adjusted analysis by propensity score (p = 0.084). No statistically significant difference was detected between mechanical and bioprosthetic valves in regard to event-free survival.
Conclusions:
Mechanical TVR is not inferior to bioprosthetic TVR in terms of occurrence of valve-related events, especially anticoagulation-related complications.
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