[Biological prostheses in the tricuspid position. The immediate and follow-up results]

The results of bioprostheses in the tricuspid position were analysed in 42 patients. 79% were in NYHA class III-IV and 43% had previous cardiac surgery. Concomitant surgical procedures were performed in 86% of the cases. Surgical mortality was 14.3%. Mean follow-up was 54 +/- 31 months. Eight patients were reoperated (5.1%/patient/year), but only 3 for the tricuspid prosthesis. Four patients, with left-sided mechanical prostheses, had systemic thromboembolic events (3.8%/patient/year) and 3 on oral anticoagulation had major haemorrhage (2.8%/patient/year). Primary tricuspid valve dysfunction occurred in two patients (1.2%/patient/year). There were no cases of tricuspid valve thrombosis. For hospital survivors, 5 and 8 years survival was 91.4 +/- 10.3% and 76.2 +/- 10.4%, respectively. The only preoperative predictor of decreased survival was pulmonary artery systolic pressure > or = 50 mmHg. Tricuspid valve replacement with a bioprosthesis was usually performed in the set of multiple-valve operation, with previous cardiac surgery in a high percentage of patients, carrying a significant surgical mortality. However, the long-term survival and the low rate of events related to the tricuspid bioprosthesis favours its use, when conservative surgery is not feasible.