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  • Title: Tricuspid valve replacement with mechanical prostheses: long-term results.
    Author: Garatti A, Canziani A, Mossuto E, Gagliardotto P, Innocente F, Corain L, Frigiola A, Menicanti L.
    Journal: J Heart Valve Dis; 2010 Mar; 19(2):194-200. PubMed ID: 20369503.
    Abstract:
    BACKGROUND AND AIM OF THE STUDY: Historically, tricuspid valve replacement (TVR) has been associated with high mortality and morbidity, and current knowledge in the long-term outcome of TVR is limited. The study aim was to review the authors' experience from a consecutive series of patients. METHODS: Between January 1990 and December 2005, a total of 43 patients (seven males, 36 females; mean age 52 +/- 14 years) underwent TVR. The etiology was rheumatic in 33 patients (77%) and degenerative disease in 10 (22%). Thirty-six patients (84%) were in NYHA class III or IV. Thirty-four patients (79%) underwent redo procedures; all patients underwent TVR with a mechanical prosthesis. RESULTS: The overall operative mortality was 16% (n = 7). Of the 36 survivors, nine (25%) died during follow up. The Kaplan-Meier survival at 2.5, 5, and 10 years was 78%, 70%, and 58%, respectively. Five patients (14%) underwent reoperation during follow up (three for tricuspid valve thrombosis) and all five survived the reoperation. Freedom from reoperation at five and 10 years was 90% and 74%, respectively. On permutation test analysis, older age, liver congestion and redo surgery were found to be the major determinants of long-term mortality. CONCLUSION: TVR carries a higher short- and long-term mortality when compared to left-heart valve surgery. A timely referral before the development of end-stage cardiac impairment might determine a further improvement in outcome.
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