[MSB-29] Comparative Analysis of Mechanical and Bioprosthetic Valves in Tricuspid Valve Replacement

This study aimed to identify whether mechanical or bioprosthetic valves offer better outcomes by analyzing early- and long-term results in tricuspid valve replacement (TVR).

A retrospective analysis was conducted with 83 patients who underwent TVR between 2014 and 2023. Forty-eight patients (31 females, 17 males; mean age: 55.7±11.65 years) underwent surgery with bioprosthesic valves, while mechanical valves were used in the remaining 35 patients (23 females, 12 males; mean age: 50.7±12.08 years). Demographic, clinical, and surgical data were analyzed. Key outcomes included early and late mortality, reoperation rates, and postoperative complications.

There was no significant difference between the mean ages of the two groups (p<0.05). Early and late mortality rates showed no significant differences between the groups. Risk factors for mortality included impaired right ventricular function, combined surgeries, and reoperations for both groups. Comorbidities were more common in the bioprosthetic group. The redo surgery rate was 67%, with higher early mortality compared to primary procedures. While 39% of the cases were combined surgeries, 61% were isolated TVR. The choice of valve type varied over the years, with an increased preference for mechanical valves in patients already on anticoagulation therapy, consistent with guideline recommendations. In the bioprosthetic group, three patients experienced valve degeneration, and two required redo TVR. In the mechanical group, one patient had a stuck valve, and two underwent redo TVR.

This study highlights that both valves have comparable outcomes in TVR. Considering patientspecific risk factors and shared decision-making with the patient are emphasized. Early surgical intervention before right ventricular deterioration may improve long-term results.