title: Reoperations after tricuspid valve repair.
abstract: OBJECTIVE
  The objective was to analyze the short- and long-term results of patients with previous tricuspid valve repair who had valve dysfunction and required cardiac reoperations.
  
  
  METHODS
  Between 1976 and 2002, 74 patients with a mean age of 53.8 +/- 12.2 years underwent valve reoperations for dysfunction of previous tricuspid valve repair. Mitral and tricuspid lesions were diagnosed in 40 patients (54%), triple valve disease (mitral, aortic, tricuspid) was diagnosed in 26 patients (35.1%), isolated tricuspid disease was diagnosed in 6 patients (8.1%), and aortic and tricuspid lesions were diagnosed in 2 patients (2.7%). Reoperations included tricuspid valve replacement in 43 patients (58.1%) and a new tricuspid valve repair procedure in the remaining 31 patients (41.9%).
  
  
  RESULTS
  Hospital mortality (30-day or within first admission) was 35.1% (n = 26). In the multivariate analysis, risk factors for hospital mortality included body mass index less than 20 kg/m2 and greater than 24 kg/m2 , triple valve disease, use of intra-aortic balloon counterpulsation, and presence of postoperative complications. The follow-up was complete in 100% of patients, with a mean follow-up of 14.2 years (range 4 months to 26 years). The late mortality was 40.5% (n = 30). Predictors of late mortality were body mass index less than 20 kg/m2 , cardiac surgery before 1991, and development of dysfunction early after tricuspid valve repair. At the follow-up closing date, 19 patients are alive (25.7%). The actuarial survival was 11.8% +/- 4.9% at 26 years.
  
  
  CONCLUSIONS
  Patients with failure of a tricuspid valve repair procedure requiring reoperation have a poor prognosis with a high mortality rate both in-hospital and in the long-term.
authors.affiliation: Department of Cardiovascular Surgery, Hospital Universitario Valdecilla, Santander, Spain. ccabmj@humv.es
authors.forename: José M
authors.initials: JM
authors.lastname: Bernal
authors.forename: Dieter
authors.initials: D
authors.lastname: Morales
authors.forename: Carmen
authors.initials: C
authors.lastname: Revuelta
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.forename: Jesús
authors.initials: J
authors.lastname: Gutiérrez-Morlote
authors.forename: José M
authors.initials: JM
authors.lastname: Revuelta
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000401:mortality*; D005260:Female; D006349:Heart Valve Diseases; D019918:Heart Valve Prosthesis Implantation / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality*; D012086:Reoperation; D014261:Tricuspid Valve / Q000601:surgery*