[Indications and results of surgery of organic involvement of the tricuspid valve].
In this study the long-term results of 121 repairs for organic lesions of the tricuspid valve are presented, and a attempt is made at selecting the respective indications for valve replacement (VR) and valvoplasty. Tricuspid valve correction was effected by VR in 37 cases (mechanical prosthesis 26, bioprosthesis 11) and by plastic procedures in 84 cases (commissurotomy 62, alone in 12 cases and combined with annuloplasty in 51 cases; annuloplasty alone in 21 cases). The early mortality rate was 9 p. 100. Subsequently, 28 patients (25 p. 100) died and 12 were lost sight of. Deaths related to the tricuspid valve (n = 7) comprised occlusive thrombosis of mechanical prosthesis (MP) in 4 cases and 3 failures of plastic surgery including 2 commissurotomies alone (TC) and 1 commissurotomy combined with annuloplasty (CA). Among the 70 survivors who could be followed up for 36 to 230 months (mean 98 months), there were: --8 failures, 5 of which required reoperation: 3 belonged to the MP group (3 occlusive thromboses) and 5 to the TC group (failure expressed as major tricuspid valve leakage); --4 mediocre results (1 bioprosthesis, 3 plastic operations). The failures of plastic surgery were mostly due to inadequate right ventricular function; --58 successful results, principally with bioprosthesis, CA and annuloplasty alone. Altogether, 93 p. 100 of CA and 92 p. 100 of bioprostheses were free from complications, as against 37 p. 100 of TC and 65 p. 100 of MP. It is concluded that TC completed by annuloplasty ensures satisfactory results, thus allowing the indications conservative tricuspid valve surgery to be enlarged.(ABSTRACT TRUNCATED AT 250 WORDS)
Chaouch
H
H
Service des maladies cardio-vasculaires, hôpital La Rabta, Tunis.
Kafsi
N
N
Ben Ismail
M
M
D000328:Adult; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D013997:Time Factors; D014261:Tricuspid Valve / Q000601:surgery*
Indications et résultats de la chirurgie des atteintes organiques de la valve tricuspide.