title: [Efficacies of tricuspid valve replacement versus repair for moderate-to-severe tricuspid regurgitation with right heart failure].
abstract: OBJECTIVE
  To compare the efficacies of tricuspid valve replacement versus plasty for moderate-to-severe tricuspid regurgitation with right heart failure.
  
  
  METHODS
  From January 2003 to June 2008, a total of 228 patients with right heart failure undergoing tricuspid valve operations were selected. And the procedures included tricuspid valve plasty (n=127) and tricuspid valve replacement (n=101). During a follow-up period of 65 months, their perioperative data were collected to evaluate the surgical outcomes.
  
  
  RESULTS
  The abnormal liver function rate and average pulmonary artery systolic pressure in tricuspid valve plasty group were lower than those in tricuspid valve replacement group (P=0.023, 0.033). In replacement group, average aortic cross-clamping time, cardiopulmonary bypass time, ventilation time and stay length of intensive care unit (ICU), the usage of inotropic drug was significantly higher than repair group (P<0.01). The early complication rate (15.8%) and case fatality rate (6.3%) of repair group were much lower than those of replacement group (27.3%, 16.8%) (P=0.042, 0.011). Long-term follow-ups revealed that the tricuspid valve thrombosis rate in replacement group was higher than that in repair group (P=0.036). And the recurrence rate of moderate-to-severe tricuspid regurgitation in repair group was higher than that in replacement group (28.7% vs 8.8%) (P=0.011). The survival rate of patients in repair group was much higher than that of replacement group at 3 months, 1, 3, 5 years post-operation. However, the differences were not statistically significant (P=0.231, 0.089, 0.133, 0.078).
  
  
  CONCLUSIONS
  For moderate-to-severe tricuspid regurgitation leading to right heart failure, the early efficacy of tricuspid valve plasty is much better than that of tricuspid valve replacement. The mid-term recurrence rate after tricuspid valve repair is higher than that of replacement.
authors.affiliation: Tianjin Medical University, Tianjin 300070, China.
authors.forename: Jintao
authors.initials: J
authors.lastname: Fu
authors.forename: Qingliang
authors.initials: Q
authors.lastname: Chen
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.forename: Feng
authors.initials: F
authors.lastname: Zhao
authors.forename: Zihou
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Cardiovascular Surgery, Tianjin Chest Hospital, Tianjin 300222, China; Email: jiangnantj@126.com.
authors.forename: Nan
authors.initials: N
authors.lastname: Jiang
mesh_terms: D006348:Cardiac Surgical Procedures; D006333:Heart Failure; D006801:Humans; D015996:Survival Rate; D014261:Tricuspid Valve; D014262:Tricuspid Valve Insufficiency