Long-term results of isolated tricuspid valve replacement.
The long-term outcome of isolated tricuspid valve replacement is unclear because this procedure is rare and usually performed in combination with replacement of other valves. The results of all 31 isolated tricuspid valve replacements carried out in 23 patients in Kyushu University Hospital between 1975 and 2004 were retrospectively reviewed. A bioprosthesis was used in 27 cases and a mechanical valve in 4. There were 2 operative deaths and 4 late deaths. One patient with a mechanical prosthesis needed redo tricuspid valve replacement due to valve thrombosis 6 months after surgery. The mean cardiothoracic ratio and functional class improved significantly postoperatively. At 15 years after tricuspid valve replacement, actuarial survival was 75.6% and freedom from valve-related events was 84.9%. For bioprostheses, freedom from structural valve deterioration at 5, 10 and 15 years was 95.2%, 95.2% and 85.7%, respectively. The long-term results of tricuspid valve replacement are considered satisfactory, and a bioprosthesis can be recommended due to its good outcome and no need for anticoagulation. We should not wait until the development of endstage cardiac impairment before carrying out tricuspid valve surgery.
Tokunaga
Shigehiko
S
Department of Cardiovascular Surgery, Kyushu University Hospital, 3-1-1 Maidashi, Fukuoka 812-8582, Japan. shiget@heart.med.kyushu-u.ac.jp
Masuda
Munetaka
M
Shiose
Akira
A
Tomita
Yukihiro
Y
Morita
Shigeki
S
Tominaga
Ryuji
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001705:Bioprosthesis; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011474:Prosthesis Design; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000503:physiopathology / Q000601:surgery*