Background. Tricuspid valve replacement (TVR) has historically been associated with high mortality and morbidity, and current knowledge of long-term results of TVR is limited. This study reviewed our experience from a consecutive series at 2 institutions. Methods. Ninety patients (65 women [72%]; mean age, 53.8 +/- 14.2 years; mean body surface area, 1.6 +/- 0.2 m(2)) underwent TVR between January 1980 and December 2005. The etiology was secondary to left-heart valve disease in 56 patients (62%), degenerative disease in 16 (18%), Ebstein anomaly in 7 (8%), and endocarditis in 11 (12%). Seventy patients (78%) were in New York Heart Association class III or IV. Sixty patients (67%) underwent redo procedures. TVR was with a mechanical valve in 46 patients (51%) and a biologic prosthesis in 44 (49%). Results. The overall operative mortality was 17.7% (16 patients). During follow-up, 16 of the 74 survivors died. Kaplan-Meier survival at 5, 10, and 15 years was, respectively, 72%, 65%, and 63%. During follow-up, 16 patients (21.6%) underwent reoperation; among them, 8 with a mechanical valve underwent reoperation for tricuspid valve thrombosis and 6 with a biologic prosthesis for tricuspid valve deterioration. However, freedom from reoperation at 5 and 10 years was similar between mechanical (86% and 76%) and bioprostheses (97% and 83%). All 16 patients survived the reoperation. Conclusions. The present experience suggests that the type of implanted prosthesis in the tricuspid position does not affect early and long-term outcomes or the reoperation rate. Timely referral before end-stage cardiac impairment develops could determine further outcomes improvement.
Twenty-Five Year Outcomes of Tricuspid Valve Replacement Comparing Mechanical and Biologic Prostheses / A. Garatti, G. Nano, G. Bruschi, A. Canziani, T. Colombo, A. Frigiola, L. Martinelli, L. Menicanti. - In: ANNALS OF THORACIC SURGERY. - ISSN 0003-4975. - 93:4(2012 Apr), pp. 1146-1153.
|Titolo:||Twenty-Five Year Outcomes of Tricuspid Valve Replacement Comparing Mechanical and Biologic Prostheses|
GARATTI, ANDREA (Primo)
NANO, GIOVANNI (Secondo)
|Parole Chiave:||HANCOCK PORCINE BIOPROSTHESIS ; POSITION ; EXPERIENCE ; IMPLANTATION ; DURABILITY|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
Settore MED/22 - Chirurgia Vascolare
Settore MED/23 - Chirurgia Cardiaca
|Data di pubblicazione:||apr-2012|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.athoracsur.2011.12.031|
|Appare nelle tipologie:||01 - Articolo su periodico|