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Tricuspid valve replacement: postoperative and long-term results
G J Van Nooten1, F Caes, Y Taeymans
1Department of Surgery, University Hospital of Ghent, Belgium.
The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1995
Summary
Tricuspid valve replacement in severely ill patients had high early mortality, with icterus being a key risk factor. Long-term survival favored mechanical prostheses over bioprostheses, especially after seven years.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Repair & Replacement
Background:
- Tricuspid valve disease often affects severely debilitated patients.
- Surgical outcomes for tricuspid valve replacement (TVR) in this population require careful evaluation.
Purpose of the Study:
- To analyze the outcomes of tricuspid valve replacement in a consecutive series of patients.
- To identify risk factors for hospital mortality and long-term survival.
- To compare the performance of different types of prosthetic valves.
Main Methods:
- Retrospective review of 146 patients undergoing tricuspid valve replacement between 1967 and 1987.
- Analysis of operative and hospital mortality, including risk factor identification.
- Long-term follow-up to assess survival rates and compare prosthetic valve types.
Main Results:
- High operative/hospital mortality (16.4%), with preoperative icterus as an independent predictor.
- Long-term survival at 60 months was 74%, decreasing to 23.4% at 180 months.
- Bioprostheses showed inferior long-term survival compared to mechanical valves, particularly after 7 years.
Conclusions:
- Tricuspid valve replacement in severely ill patients carries significant early risks.
- Preoperative icterus is a critical predictor of hospital mortality.
- Mechanical tricuspid valve prostheses demonstrate superior long-term durability compared to bioprostheses.