[Tricuspid valve replacement and anticoagulation therapy: a report of 70 cases].
OBJECTIVE
To evaluate the operative indication, the choice of valve prostheses, and the method of anticoagulation therapy of tricuspid valve replacement (TVR).


METHODS
From May 1998 to January 2008, 70 patients underwent TVR. There were 59 cases of rheumatic heart diseases. The operations included mitral and tricuspid valve replacement for 37 cases, triple valve replacement for 18 cases, isolated TVR for 13 cases, and tricuspid and aortic valve replacement for 2 cases. All the patients received oral anticoagulant therapy (warfarin) 2 d after the operations.


RESULTS
There were 3 in-hospital deaths (4.3%) and 1 late death (0.4%). The follow-up rate was 88.1%, and the cumulative follow-up was 243.5 patient-years (pty). The anticoagulation-related event rate was 2.9% pty, and the mean INR value of 643 out-patient samples was 1.87 +/- 0.68. Post-operative heart function NYHA classification: 52 cases in class I to II, and 7 cases in class III.


CONCLUSIONS
TVR should be indicated for severely damaged and deformed tricuspid valve of rheumatic heart diseases. Bileaflet mechanical valve is a suitable prosthesis for TVR. The optimal anticoagulation therapy intensity of TVR needs to be investigated.
Dong
Li
L
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Xiao
Xi-jun
XJ
Zhang
Er-yong
EY
Hu
Jia
J
Yuan
Hong-sheng
HS
Shi
Ying-kang
YK
Ren
Li
L
D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin