Tricuspid regurgitation associated with mitral valve disease: repair and replacement.
Between January 1975 and June 1988, 156 patients with combined mitral and tricuspid valve disease underwent mitral and tricuspid valve repair or replacement. There were 127 (81%) patients with tricuspid valve repair and 29 (19%) patients with tricuspid valve replacement. Hospital mortality was 14% and was strongly influenced by preoperative pulmonary hypertension (systolic pressure greater than 65 mm Hg) and poor left ventricular function (ejection fraction less than 0.4). Five-year survival for the entire series was 57% +/- 5%; 12-year survival was 44% +/- 9%. Ejection fraction was the only age-adjusted risk factor for long-term survival. Of the patients who underwent tricuspid annuloplasty, 91% +/- 4% were free from reoperation after 10 years, indistinguishable from valve replacement (90% +/- 7%). Our tricuspid annuloplasty is simple and effective, and exhibits excellent long-term durability as well as immediate hemodynamic improvement.
Heart Institute, Hospital of the Good Samaritan, Los Angeles, California.
G L
GL
Kay
S
S
Morita
M
M
Mendez
P
P
Zubiate
J H
JH
Kay
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume; D014262:Tricuspid Valve Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*