Abstract
Background: Tricuspid valve replacement (TVR) is rarely performed and is associated with a high morbidity and mortality. We report our experience with TVR and related adverse events. Methods: Between January 1996 and December 2007, 35 patients underwent TVR with mechanical (n = 33) or bioprosthetic (n = 2) valves. Twenty-nine patients underwent concomitant cardiac procedures. Results: All patients completed follow-up (mean 47 months). Thirty-day mortality was 20 % (n = 7). Risk factors included perioperative low arterial blood pressure (p = 0.000), New York Heart Association (NYHA) functional class III or IV (p = 0.001), severe pulmonary hypertension (pulmonary arterial pressure greater than 60 mmHg) (p = 0.000), hepatic dysfunction (p = 0.000), ascites (p = 0.003), and reoperation (p = 0.015). Late mortality occurred in five patients. Valve-related complications included bleeding (n = 1) and stroke (n = 1). Kaplan-Meier estimates of 1-, 5- and 10-year survival (including early mortality) and event-free survival were 77.1 %, 60 %, and 54.3 % and 91.1 %, 80.6 %, and 55.9 %, respectively. Severe pulmonary hypertension was the only predictor of late mortality (p = 0.001). Among survivors, the mean NYHA class improved from 2.8 to 1.1 (p = 0.000). Conclusions: Although early outcome after TVR is suboptimal, long-term survival and functional improvement is satisfactory.
Key words
heart valve surgery - cardiovascular surgery - heart disease
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Assoc. Prof. Ali Civelek
Department of Cardiovascular Surgery
Marmara University School of Medicine
Eston Camlievler. Ardic Apt. A/6 Blok. Daire 29
34752 Icerenköy, Istanbul
Turkey
Telefon: + 90 21 64 69 06 63
Fax: + 90 21 63 25 24 26
eMail: alicivelek@tnn.net
